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It’s one thing when Newt Gingrich or Rick Santorum say Romneycare was the inspiration for Obamacare. Such charges can be written off or minimized as political exaggeration. But how about when an academic study in Health Affairs, a peer-reviewed, health policy journal, says it? The publication just published an analysis of Mitt Romney’s health reform in Massachusetts. And, at least for political pundits, this is the big takeaway (bold for emphasis):
Just as Massachusetts’s 2006 health reform legislation provided the template for the Affordable Care Act, so the state’s experience under that legislation provides an example of the potential gains under federal health reform.
Indeed, the whole point of the study is to try and forecast the impact of Obamacare by looking at Romneycare. Don’t be surprised if the research, conducted by professors from the University of Minnesota and Harvard, gets a mention at tonight’s GOP debate. But the study says a lot more than that. Here are some numbers regarding coverage and affordability:
— Health insurance coverage among non-elderly adults in Massachusetts was at 94.2 percent in 2010 … well above the 86.6 percent estimate for 2006, just before implementation of the key elements of the state’s health reform initiative.
— By 2010, 12.1 percent of Massachusetts adults had a period of uninsurance during the prior year—down from 19.5 percent in 2006—and fewer than 3 percent were long-term uninsured—down from 8.8 percent in 2006.
— More than two-thirds of non-elderly adults (68.0 percent) reported coverage through an employer. This is significantly higher than the level in 2006 (64.4 percent), before health reform. In 2010, as in earlier years, there was no evidence of public coverage “crowding out” employer-sponsored insurance under health reform in Massachusetts.
— In 2010 compared to 2006, non-elderly adults were more likely to have a usual place to go when they were sick or needed advice about their health (up 4.7 percentage points), and were more likely to have had a preventive care visit (up 5.9 percentage points), a specialist visit (up 3.7 percentage points), multiple doctor visits (up 5.0 percentage points), and a dental care visit (up 5.0 percentage points.)
— During the 2006–10 period there were drops in the shares of adults reporting a hospital stay and using the emergency department—the first shifts in those measures since 2006. In contrast, data for the nation as a whole show a small increase in emergency department use by non-elderly adults during this period—from 20 percent in 2006 to 21 percent in 2010.
— Workers were more likely to rate their employer-sponsored insurance plans as very good or excellent in 2010 than they were in 2006, based on the range of services offered and their choice of doctors and other providers. They also were no more likely in 2010 to report problems with expensive medical bills or doctor’s charges that were not covered by their plan.
— The share of non-elderly adults who reported high levels of out-of-pocket health care spending (10 percent or more of family income) was lower in 2010 (6.1 percent) than in 2006 (9.8 percent). Consistent with the lower burden of out-of-pocket expenses, the share of adults reporting unmet need for care because of cost was down in 2010 relative to 2006 for all of the types of care examined except prescription drugs and dental care.
— Strong and sustained gains in the share of non-elderly adults in Massachusetts who reported their health as very good or excellent, with an increase from 59.7 percent in 2006 to 64.9 percent in 2010
— The share of adults reporting that they did not get needed care was down for doctor care, medical tests, treatment or follow-up care, and preventive care over this five-year period.
As Romney said when he said when he signed the health reform bill back in 2006, the plan represents a “vision to insure all our citizens.” Reducing costs, however, is quite another thing, as the study notes:
There is, however, reason to be concerned about employer-sponsored insurance premiums because health care costs in the state continue to rise. Data from the Insurance Component of the Medical Expenditure Panel Survey, a national survey of employers, indicate that in 2006 the average employee contribution toward premiums in Massachusetts was $1,011 for single coverage and $3,128 for family coverage. By 2010, the average employee contribution had increased to $1,200 for single coverage and $3,444 for family coverage, although the change in the employee contribution for family coverage was not statistically significant. Health care costs in Massachusetts, as in the rest of the country, continue to grow faster than wages and inflation. … Consistent with that finding, Massachusetts continues to struggle with escalating health care costs, reflecting the decision to defer addressing costs in the 2006 legislation so as not to hold up the expansion in coverage.
The authors conclude that based on the Romneycare experience, Obamacare will improve coverage and not kill employer-based insurance, but containing costs will be a “considerable challenge.” That is probably the avenue Romney should use to a) attack Obamacare and b) present his own national health reform. But this study will perpetuate the meme that Romneycare was the prototype for Obamacare. Santorum hammered Romney on this point at the last debate more effectively than any other candidate throughout this campaign season, probably because he understands the issue better than his rivals. We’ll see if he or Gingrich follows up tonight.
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