Health Insurance Coverage in Massachusetts: Estimates from the 2008 Massachusetts Health Insurance Survey

Health Insurance Coverage in Massachusetts:Estimates from the 2008 Massachusetts Health Insurance SurveyDeval L. Patrick, GovernorCommonwealth of MassachusettsTimothy P. MurrayLieutenant GovernorJudyAnn Bigby, SecretaryExecutive Office of Health and Human ServicesSarah Iselin, CommissionerDivision of Health Care Finance and PolicyUpdated March 2009Sharon K. Long, Allison Cook, and Karen StockleyUrban Institute 1Executive SummaryNearly all Massachusetts residents had health insurance coveragein 2008. Only 2.6% were uninsured this past summer, when the 2008 Massachusetts Health Insurance Survey (HIS) was conducted.Who are the Uninsured?Those most likely to be uninsured were non-elderly adults, Hispanic residents, and residents with family income less than 300% of the federal poverty level (FPL). The uninsurance rate for non-elderly adults was 3.7%, compared to only 1.2% for children and 0% for elderly adults. Among Hispanic residents, 7.2% were uninsured, arate more than twice that of non-Hispanic residents (less than 3%). Some 5% of residents with family income less than 300% of the FPL were uninsured, compared to about 2% of those with family incomes between 300 and 500% of the FPL, and less than 1% of those with family income at 500% of the FPL or higher.Changes in Uninsurance Since 2007These estimates suggest that uninsurance has continued to drop in Massachusetts since 2007. Estimates based on the 2007 HIS and the Current Population Survey put the uninsurance rate in Massachusetts in 2007 at just over 5% for the total population, at between 2 and 3% for children, and at 7 to 8% for non-elderly adults. The 2007 Massachusetts Health Reform Survey1also estimated a 7% uninsurance rate for non-elderly adults in fall 2007. (For more information on the different sources of estimates of health insurance coverage in Massachusetts, see http://www.mass.gov/Eeohhs2/docs/dhcfp/r/pubs/08/est_of_uninsur_rate.pdf.)Type of Insurance CoverageAmong Massachusetts residents with insurance coverage, the majority of children (70%) and non-elderly adults (81%) had employer-sponsored coverage, while 89% of elderly adults were covered by Medicare. Children were twice as likely as non-elderly adults to be enrolled in public or other coverage (29% versus 15%). Massachusetts residents who were in fair or poor health or who had activity limitations because of health problems were more likely to be enrolled in Medicare, public, or other coverage than were those who were in better health and without limitations.Knowledge of Health ReformKnowledge of health reform appeared to be widespread, with more than 8 out of 10 Massachusetts households aware of the individual mandate in 2008.Support for Health ReformSupport for reform was also quite common—nearly 3 out of 4 households in Massachusetts supported health reform in 2008. This is up from the 64% supporting health reform in September 2006.2Access to Health CareThese charts focus on health insurance coverage in Massachusetts in 2008. A second set of charts, to be released ata later date, will present data on access to health care.Health Insurance Coverage in MassachusettsMassachusetts Division of Health Care Finance and Policy1This survey, which collected data in fall 2006, 2007 and 2008, was conducted by the Urban Institute with funding from the Blue Cross Blue Shield of Massachusetts Foundation, the Robert Wood Johnson Foundation, and the Commonwealth Fund.2Blendon, RJ, T Buhr, C Fleischfresser, and JM Benson. “The Massachusetts Health Reform Law: Public Opinion and Perception” November 2006. Available at: http://www.bcbsmafoundation.org/foundationroot/en_US/documents/2006HealthReformPollingreport.pdf. 2Health Insurance Coverage in MassachusettsMassachusetts Division of Health Care Finance and PolicyIntroductionTable of ContentsExecutiveSummary1Introduction2Uninsurance3Type of Coverage 17IndividualMandate31Support forReform34The 2008 Massachusetts Health Insurance Survey (HIS) provides information on health insurance coverage and access to and use of health care for the non-institutionalized population in Massachusetts. In the survey, an adult member of the household responded to questions about the health insurance coverage and demographic information for all members of the household. More detailed socioeconomic characteristics and health care information were collected for one randomly selected household member and other members of his or her family who were residing in the household. In order to ensure that the survey covered nearly all residents of Massachusetts, a dual sample frame was employed, combining a random-digit-dial (RDD) sample with an address-based sample. The decision to rely on the dual-frame sample for the 2008 HIS reflects the changing telephone environment as more and more households are relying on cell phones, which are not called in RDD surveys. We believe this dual-frame sampling approach combined with an improved survey instrument designed to better collect i