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Coverage Now Nearly Universal in Massachusetts

By John Reichard, CQ HealthBeat Editor

JANUARY 5, 2009 -- Looking at the state as a whole, health insurance coverage is now nearly universal in Massachusetts, with the uninsured rate dropping from just over 5 percent in 2007 to 2.6 percent in 2008, according to a new survey. However, some sub-groups of the population had considerably high uninsured rates, notably Hispanics and residents with household incomes below 300 percent of the federal poverty level.

Released Dec. 26 by the Washington, D.C.-based Urban Institute, the survey last summer of 4,910 Massachusetts households found that 7.2 percent of Hispanic residents were uninsured, compared to less than 3 percent of non-Hispanic residents. About 5 percent of residents with family income below 300 percent of the federal poverty level were uninsured, compared to about 2 percent of those with family incomes between 300 percent and 500 percent of the federal poverty line. Less than one percent of those with family incomes five times or higher than the poverty line lacked health benefits.

Massachusetts adopted a law in 2006 requiring individual residents to carry health insurance and employers to provide coverage or pay a fee if they failed to do so. The law provides subsidies to low-income residents to buy coverage if they are not covered by public programs, which were expanded under the overhaul. The state's Division of Health Care Finance and Policy estimated in August that some 439,000 people have enrolled in private or subsidized coverage since the law was passed. About 8.6 percent of the state's population were uninsured before Massachusetts adopted the law.

According to the latest U.S. Census Bureau figures, which are based on 2007 data, 15.3 percent of the nation's population is uninsured. The uninsurance rate nationally for Hispanics was 32.1 percent, according to the Census figures. Although the Massachusetts plan is viewed widely as a reform model, the state is atypical in that its uninsured population was relatively low before the law was passed and it had access to a relatively large number of federal dollars. In addition, costs associated with the overhaul law have raised questions about its long-term sustainability.

However, the Urban Institute survey found strong support for the law, with three out of four households backing it in 2008, up from 64 percent in September of 2006. Of Massachusetts residents with insurance coverage, 68 percent obtain their benefits through their employers, 15 percent through Medicare, and 17 percent through other publicly funded programs including Medicaid.

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