The Impacts of Healthcare Reform on Access to Care and Health Behaviors in Low-Income Individuals: Evidence From Massachusetts.
Meiselbach, Mark.
2015
- In 2006 Massachusetts passed legislation aimed at extending health coverage to nearly all of its citizens. Key elements of the reform include provisions directed at extending coverage to low-income individuals and a mandate requiring nearly all residents to be enrolled in a qualifying health plan. While past literature illustrated the impacts of the reform on access to care, preventative care, and ... read morehospitalization, little research has been done to isolate the disparate effects the reform had on individuals earning below 300% of the Federal Poverty Level, who received subsidies for health plans. This paper not only identifies the greater impact on this subpopulation, but also focuses on specific health behaviors, a relatively novel field of study in health economics. This paper makes a unique attempt to identify the relationship between the reform and improvements in the health behaviors of low-income individuals in Massachusetts. I use a difference-in-differences strategy that compares observations in Massachusetts during the implementation and post- implementation periods of reform to observations before reform and observations in comparison states. A difference-in-difference-in-differences strategy is used to isolate the differential impact on low-income individuals within Massachusetts. Using the Behavioral Risk Factors Surveillance System (BRFSS), I show that the reform had its greatest impact in low-income individuals in several measures of access to care as well as health behaviors.read less
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