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Does Universal Coverage Improve Health? The Massachusetts Experience
Author(s) -
Courtemanche Charles J.,
Zapata Daniela
Publication year - 2013
Publication title -
journal of policy analysis and management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.898
H-Index - 84
eISSN - 1520-6688
pISSN - 0276-8739
DOI - 10.1002/pam.21737
Subject(s) - legislation , subsidy , health care reform , health care , health reform , health policy , environmental health , mental health , health insurance , public economics , actuarial science , robustness (evolution) , gerontology , medicine , psychology , business , economics , political science , economic growth , psychiatry , biochemistry , chemistry , law , market economy , gene
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 reform. Using data from the Behavioral Risk Factor Surveillance System, we provide evidence that health care reform in Massachusetts led to better overall self‐assessed health. Various robustness checks and placebo tests support a causal interpretation of the results. We also document improvements in several determinants of overall health: physical health, mental health, functional limitations, joint disorders, and body mass index. Next, we show that the effects on overall health were strongest among those with low incomes, nonwhites, near‐elderly adults, and women. Finally, we use the reform to instrument for health insurance and estimate a sizeable impact of coverage on health.