Two US-based economists ran the numbers and found large, positive effects for near-universal healthcare on the self-assessed health of individuals in Massachusetts. Their findings are of interest, not least because ‘Obamacare’ – the federal health care reform legislation – was patterned after the reforms that presidential candidate Mitt Romney introduced in Massachusetts when he was Governor.
In 2006, Massachusetts passed health care reform legislation designed to achieve nearly universal coverage through a combination of insurance market reforms, mandates, and subsidies that later served as the model for national health care reform. Using individual-level data from the Behavioral Risk Factor Surveillance System, we provide evidence that health care reform in Massachusetts led to better overall self-assessed health. An assortment of robustness checks and placebo tests support a causal interpretation of the results. We also document improvements in several determinants of overall health, including physical health, mental health, functional limitations, joint disorders, body mass index, and moderate physical activity. The health effects were strongest among women, minorities, near-elderly adults, and those with incomes low enough to qualify for the law’s subsidies. Finally, we use the reform to instrument for health insurance and estimate a sizeable impact of coverage on health. The effects on coverage were strongest for men, non-black minorities, young adults, and those who qualified for the subsidies, while the effects of coverage were strongest for women, blacks, the near-elderly, and middle-to-upper income individuals.
Charles J. Courtemanche and Daniela Zapata, “Does Universal Coverage Improve Health? The Massachusetts Experience“, NBER Working Paper 17893 (March 2012).
An ungated, earlier version of this paper can be downloaded here.