Can the reform law replicate success in Massachusetts?

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Although health reform has proven successful thus far in Massachusetts, industry experts differ on whether the state's achievements can apply to the rest of the country.

Massachusetts now boasts the country's highest rate of residents with health insurance (98 percent), decreased emergency room visits (down 4 percent) and more preventive care visits (up 5.9 percent). Plus, mammograms, colon cancer screenings and prenatal care visits have increased, and 150,000 people have stopped smoking, the Associated Press reported.

"The first lesson is that you can meet the goals we set out in Massachusetts, you can cover the majority of the uninsured and fix the broken [healthcare] market," MIT economist Jonathan Gruber, who helped craft both the Massachusetts and federal reform laws, told the AP. What's more, he added, "you can do so with broad public support" since roughly 60 percent of Massachusetts residents support the reform law.

But some negatives remain in the state's healthcare market, including long waits of 48 days for primary care doctor appointments, and more than 50 percent of primary care doctors aren't taking new patients anymore, the AP noted.

Other industry experts believe a federal policy can replicate one state's success. "There are many unintended consequences when Washington tries to design a policy that meets the very different needs of states as diverse as Massachusetts and, say, New Mexico," Josh Archambault, healthcare policy director for think tank Pioneer Institute said, told The Boston Globe.

One reason replication is difficult is the variation in states' populations. Alain Weil, executive director of the National Academy for State Health Policy, thinks the Commonwealth State is better set up for healthcare reform. "Massachusetts is culturally more open to that kind of a bargain," he said.

Other states' uninsured population could respond differently to a penalty for not having insurance than people in Massachusetts, where a large proportion already had insurance before the state law passed. "I think a 30-year-old in Massachusetts, because of cultural, political and economic reasons, is probably going to view the value of insurance very differently than a cattle hand in Texas," Joshua Archambault, director of healthcare policy at the Pioneer Institute, told the Globe.

To learn more:
- see the Boston Globe article
- read the Associated Press article

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