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Imagine a world in which recessions don't mean uninsurance

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One of the awful consequences of recessions in a world of employer-based health care is that a lot of people lose their health-care insurance when they lose their jobs. But as the latest study on the Massachusetts reforms shows, that's not happening in the Bay State. "Unemployment among working-age adults in Massachusetts rose from 4.4 percent in December 2006 to 9.1 percent in December 2009" and "state revenues fell by $2.6 billion between fiscal years 2008 and 2009," but there was no corresponding rise in the number of uninsured, nonelderly residents*, which is sitting stubbornly at 4.8 percent.

And for all the bad press the reforms have gotten in some quarters, support remains stubbornly high. This study looks at Fall 2009, when we were still deep in recession and thus a period in which you might've expected some retrenchment on social spending, but nope: support stood at 67 percent.

Massachusetts still has a cost problem, as they didn't really do anything to address cost in the original reform package, but as far as their coverage expansion goes, it's working and the state likes it. That won't be a surprise to people who remember that even Tea Party-favorite Scott Brown supports the plan, but it's worth reminding people of. Nationally, we're going to need to do a lot more to control costs, but the Affordable Care Act pairs the basic coverage structure that worked in Massachusetts with the sort of serious starts at cost control that Massachusetts put off till later.

*The elderly, of course, have Medicare.

Photo credit: By Steven Senne/Associated Press

By Ezra Klein  |  June 10, 2010; 5:06 PM ET
Categories:  Health Reform  
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Comments

If the legislature did pass the types of measures necessary to keep costs under control, what would that do to public support? Isn't that why those measures weren't included in the first place?

Posted by: ath17 | June 10, 2010 6:09 PM | Report abuse

It's good to hear that Massachusetts residents are able to reap the benefits of federal funds taken from other states. I'm left to wonder, though, what happens when the Massachusetts socialized medicine program has to begin to be self-sufficient; that is, how do they pay their own bills once the funds taken from other states are exhausted?

Posted by: rmgregory | June 10, 2010 6:37 PM | Report abuse

--"And for all the bad press the reforms have gotten in some quarters, support remains stubbornly high."--

Slavery had a lot of proponents in the 1800s, didn't it?

Posted by: msoja | June 10, 2010 10:36 PM | Report abuse

--"*The elderly, of course, have Medicare."--

Which will be bankrupt, soon.

Posted by: msoja | June 10, 2010 10:46 PM | Report abuse

Ezra,

As a Bay State actuary who still believes our Commonwealth has the best health care system in the nation (which may change once the Exchanges are set up), I have to strongly disagree with you that the biggest weakness of our Commonwealth's system is the lack of cost control. There's a reason that the biggest disapproval of the Bay State's system comes from residents who buy their health insurance on the Connector: the subsidies simply aren't sufficient, and the risk pools are totally out of whack. A richer plan from the same company on a given can be cheaper than a less generous plan from the same company. Plans with tighter networks (i.e., Fallon) can be more expensive than plans with wider networks. And a 64-year-old still has to drop at least $785/mo. for a Gold Tier (0.93 AV) HMO policy (which tells me the Connector has become a dumping ground for employers who have trouble getting health insurance).

Well, that's just my take. While the Commonwealth has been revolutionary, and has a system far better than that of any other state, we've still got a lot farther to go than what you advertise.

Posted by: moronjim | June 10, 2010 11:04 PM | Report abuse

--"While the Commonwealth has been revolutionary, and has a system far better than that of any other state, we've still got a lot farther to go than what you advertise."--

All the way into the dumper farther, eh?

Posted by: msoja | June 10, 2010 11:08 PM | Report abuse

--"support stood at 67 percent."--

Your reliance on such factoids to make your points is one of the ways I know what a fraud you are, Klein.

You can always justify tyranny if you can jigger the polls the way you need to.

Posted by: msoja | June 10, 2010 11:15 PM | Report abuse

You guys should stop complaining cuz one the health care we have now isnt as good as it was supposed to be. also the law has just been signed give it a try u guys are too hard on democrats they went to college and we voted for most of these people.so if u want to say u have the right to choose tell that to ur congress men or state official. as for obama people are just tryin to make it look like america made a mistake he has done things to help us and we had a full 8 years of a terrible president and i will be so as happy as ever when a obama fixes bush's mistakes. You can find full medical coverage at the lowest price from http://bit.ly/cmg7mK obama has to put up with the wo0rld judging his every move and trying to fix the mess we are in we are lucky anyone wants to be our president. STOP COMPLAINING AND GIVE HIM A BREAK. i wanna see one of yall do what he sas done. some people are just so ignorant.

Posted by: sherryhope11 | June 11, 2010 6:42 AM | Report abuse

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