A Healthy Blog

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

Sobering Report Points To Challenges in Access and Affordability

Sobering Report Points To Challenges in Access and Affordability

March 23, 2016

This. The headline above topped the Blue Cross Blue Shield Foundation's annoucement of the latest results from the Massachusetts Health Reform Survey. The sobering report has some good news - overall, coverage is still very strong in Massachusetts, with 95.7 percent of nonelderly adults reporting having insurance.

But the report is newsworthy for the challenges it lays bare. Just having an insurance card is not nearly enough.

Almost half of insured adults (46.9 percent) reported a major access challenge: 1) difficulty finding a provider that would accept their insurance; 2) difficulty finding a provider that was accepting new patients; or 3) difficulty getting an appointment with a provider in a timely manner. Of these, 37% did not get needed health care in the past year.

Also, more Bay Staters reported going without care due to costs than in previous years. While this figure is 12.6% for those making more than 4 times the poverty level, it's 28% for those earning below 138% of the poverty level (around $16,200 annual income for an individual). We suspect many of these people are not in the MassHealth program, which has virtually no cost sharing, but are in employer plans with co-pays and deductibles that put a strain on low and moderate income people.

The situation is worse for those with a health limitation or a chronic health condition:

Health status and income affect ability to get care

HCFA is supporting the "No Copay" bill that would eliminate cost sharing for high-value preventive care treatments for chronic disease, like asthma inhalers or insulin for diabetics. This would go a long way in helping people with chronic conditions afford their care and prevent expensive acute episodes.

The survey also asked about dental coverage for the first time. Around 69% percent of us have dental insurance that includes coverage for routine dental care, leaving almost a third of the state without good dental coverage. We know that oral health care is integral to overall health, and we are working to make sure that the next generation of coverage and care coordination systems fully integrate oral health along with medical care. 

     -- Brian Rosman