For some time now, many of us involved in Massachusetts health reform have asked ourselves the question: is there any evidence that the reforms led to improved health on the part of new enrollees? We know there have been dramatic improvements in insurance coverage, physician and other provider access, decreases in medical debt, and more. But the evidence of a benefit in improved health? There was no compelling, hard evidence one way or another.
Two economists, Charles Couremanche of the University of Louisville College of Business, and Daniela Zapata from the University of North Carolina Department of Economics, using data from the CDC's Behavioral Risk Factor Surveillance System, "provide evidence that health care reform in Massachusetts led to better overall self-assessed health." Report available here.
Not just correlation, they found causation, and positively affecting 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."
The results mirror findings last year by my HSPH colleague Kate Baicker and others showing that low-income Oregonians who were allowed to enroll in that state's Medicaid program showed improved self-reported physical and mental health.
Both the Massachusetts and Oregon results show self-reported results, and it will take some time to verify these results with other data.
Still, there has been a message out there among opponents of health reform -- state and national -- that health insurance, and Medicaid in particular, doesn't matter. It does matter. And it saves lives.
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