This report presents the latest findings from the Massachusetts Health Reform Survey (MHRS), which has been conducted since 2006 to monitor the impact of the Massachusetts health reform law.

This year's report shows that more than 90% of nonelderly adults have a usual source of care, up from 86% in 2006, and utilization of basic health services also increased. There is evidence that having unmet need for medical care is a problem, particularly for lower-income adults.

• Full report
• Chartbook

The authors also published a companion article in Health Affairs on January 25, 2012, "Massachusetts Health Reforms: Uninsurance Remains Low, Self-Reported Health Status Improves As State Prepares To Tackle Costs."
 

SHADAC Research Assistant Jessie Kemmick-Pintor and Lynn Blewett published an article in the October 2011 issue of Minnesota Physician as part of the journal’s special focus section on health reform. "Immigrant access to health care" reviews the key provisions of national legislation pertaining to access to care for immigrants.

Using insurance coverage among immigrants to address health care access issues, the authors find that across the U.S. and within Minnesota, non-citizens are four times more likely to be uninsured than their citizen counterparts.

Federal policies have hindered coverage among the immigrant population include.  The authors foresee an increasing reliance on formal and informal safety nets to provide care for uninsured immigrants under the restrictions of the Affordable Care Act. At the same time, less political will and lower state and federal tax revenue is likely to be directed to the safety net.

Citation:

Pintor, J.K. and L.A. Blewett.  "Immigrant access to health care," Minnesota Physician 25(7): 22-23.

Lynn Blewett and Elizabeth Lukanen participated in the final all-grantee meeting of the State Health Access Program (SHAP), held August 23-24, 2011, in Washington, DC.  Lynn led a session on Health Reform and Provider Capacity.

Her presentation "Health Reform and Provider Capacity," focused on the importance of conducting provider capacity at a state level given the passage of health reform, key analytic steps to this type of analysis and alternative ways to monitor and assess provider capacity issues.

Download a PDF version of these slides.

Objectives. We sought to determine whether aggregate national data for American Indians/Alaska Natives (AIANs) mask geographic variation and substantial subnational disparities in prenatal care utilization.

Methods. We used data for US births from 1995 to 1997 and from 2000 to 2002 to examine prenatal care utilization among AIAN and non-Hispanic White mothers. The indicators we studied were late entry into prenatal care and inadequate utilization of prenatal care. We calculated rates and disparities for each indicator at the national, regional, and state levels, and we examined whether estimates for regions and states differed significantly from national estimates. We then estimated state-specific changes in prevalence rates and disparity rates over time.

Results. Prenatal care utilization varied by region and state for AIANs and non-Hispanic Whites. In the 12 states with the largest AIAN birth populations, disparities varied dramatically. In addition, some states demonstrated substantial reductions in disparities over time, and other states showed significant increases in disparities.

Conclusions. Substantive conclusions about AIAN health care disparities should be geographically specific, and conclusions drawn at the national level may be unsuitable for policymaking and intervention at state and local levels. Efforts to accommodate the geographically specific data needs of AIAN health researchers and others interested in state-level comparisons are warranted.

Click here for links to the full article.

We use data from the National Health Interview Survey (2000-2006) to examine the social determinants of health insurance coverage and access to care for immigrant children by 10 global regions of birth. We find dramatic differences in the social and economic characteristics of immigrant children by region of birth. Children from Mexico and Latin America fare worse than immigrant children born in the U.S. with significantly lower incomes and little or no education. These social determinants, along with U.S. public health policies regarding new immigrants, create significant barriers to access to health insurance coverage, and increase delayed or foregone care. Uninsured immigrant children had 6.5 times higher odds of delayed care compared with insured immigrant children.

Click here for the full article.