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Massachusetts health care — wonky, with a healthy dose of reality

Another Good News / Bad News Report: CHIA's 2014 Health Insurance Survey Released

Another Good News / Bad News Report: CHIA's 2014 Health Insurance Survey Released

May 5, 2015

CHIA, the state’s Center For Health Information and Analysis, released their Findings from the 2014 Massachusetts Health Insurance Survey today. The package includes a report, and chartpack (with powerpoint), along with detailed data tables and a methodology explainer.

The survey is back after not being conducted for two years, with a new methodology that probably reaches more low income and uninsured people. The new methodology means you can't directly compare the numbers in the 2014 results to past surveys; hence the different colors and break in the line in the chart below. The survey was conducted during May through July of 2014. They plan to resume annual surveys, with the 2015 survey being fielded starting in a week or so.

Lots and lots of numbers here. If you're into this blog, you'll probably want to look at the whole thing. Our big takeaways:

Insurance Coverage rates in MA

Coverage

  • Coverage rates high: Our health insurance coverage rate remains very strong. In total, 96.3% of all Bay Staters had insurance at the time of the survey. For kids, it’s even better, with 98.2% covered.
  • Churn and gaps are still problems for many. Adults surveyed reported that 12.3% of them had a period of being uninsured in the past year.
  • Who is left out: The remaining uninsured are working age adults, disproportionately male, single, Hispanic and lower income. Almost all are likely eligible for state assistance through MassHealth or the Connector.

 

Source and Use of Care

  • With high coverage comes high rates of people reporting a usual source of care other than an emergency room. Some 88% of the state’s residents reported having a usual source of care.
  • But real racial and ethnic disparities still exist in this measure. The rate was 90.3% for non-Hispanic Whites, but 78.9% and 80.7% for Blacks and Hispanics, respectively.

Types of care forgone due to cost 2014

Affordability

  • More than one in three adults are skipping care they need because of cost. Overall, the rate was 27.9%, and it was 35.2% for adults. While the rate of those reporting unmet need due to cost is very high among the uninsured, even those with coverage throughout the year had a 25.3% rate.
  • The biggest unmet need due to cost is dental care. For adults, 25.9% reported not getting dental care they needed due to cost.

The policy implications to us are clear from the data:

  • The expansion of public programs through state health reform and the ACA has been a huge success. But we must expand outreach and simplify the application and enrollment process to reach the uninsured and assure continuous coverage for those eligible.
  • Health disparities remains a problem, requiring serious, ongoing state responses.
  • Our success in controlling the growth rate in total medical spending as not led to relief for patients, who continue to ration their needed care because of high cost sharing. We need to reduce cost sharing for high-value services, and find ways to integrate oral health into broader medical care.

HCFA is working hard on all these issues, and we hope policymakers will take today's survey results as another wake-up call for the critical agenda facing the state on health care.

             - Brian Rosman