Mass. Health Coverage Law Linked To Lower Mortality Rate

Three-hundred and twenty. It's estimated that is the number of deaths prevented each year as a result of the 2006 Massachusetts health care law, a Harvard School of Public Health report says.

The decrease in the state's mortality rate is the most concrete proof that Massachusetts' health insurance mandate is improving people's health.

When people have health insurance, they are more likely to get preventive care, go to the doctor when they become ill, and live longer. At least that was the expectation when Massachusetts passed the health coverage law back in 2006.

Now, there’s evidence of that link, in the study out Monday in the Annals of Internal Medicine.

It found that in the first four years of mandatory health insurance, the state’s death rate dropped 2.9 percent, as compared to similar counties outside Massachusetts that did not expand health coverage.

"We already had a large body of research that showed the uninsured rate had dropped, people were able to access services, and that they felt better. This adds another important piece to that, which is that people are living longer," said Dr. Ben Sommers, the Harvard report's lead author.

Sommers said the most significant declines were in "things like cancer, infections, heart disease and other conditions that medical care might either prevent or treat or at least reduce the risk of death from. Meanwhile in some other causes of death that are less amenable to health care, such as car crashes, homicide, suicide, we didn’t find any statistically significant changes."

That 2.9 percent decrease is for everyone in the state. White residents are living longer, but the biggest improvement is for blacks, Asians and Latinos, whose death rates dropped 4.6 percent.

So, as a result, is Massachusetts on a path to eliminate health disparities?

Boston Public Health Commission Director Barbara Ferrer says she’s hopeful. She says this new study builds on prior research that showed that health coverage is reducing income and racial disparities in Massachusetts.

"I would be surprised if we didn’t see a closing of the gap that could be attributed to improved coverage rates," she said. "We have to be a little bit wary that you can’t just insure people without making sure that they have access to high-quality services, but certainly in Massachusetts we’re able to do both."

The report’s authors say the findings are encouraging for states in the early stages of implementing the Affordable Care Act.

But Alan Weil, director of the National Academy for State Health Policy, says many opponents already knew that there would be health benefits to insuring more people through the federal law.

"But [opponents] don’t feel that the nation can afford it or that it’s an appropriate role for government," he said. "And if that’s the basis of your opposition, I think additional evidence that it might improve people’s health is unlikely to change your overall view of the law."

Still, Weil says, this study will draw attention because it is some of the best evidence so far that making sure people have insurance leads to better health and longer lives.

Douglas Holtz-Eakin — of the American Action Forum, a conservative advocacy group — is more critical of the report. He says the study does not prove that coverage lowers death rates.

He said the authors “don’t directly observe how people interact with the medical community," and that they reach their conclusions “by inference and process of elimination. There’s a limit to that.”

Holtz-Eakin added: “If there’s one thing we’ve learned about health care reform, Massachusetts doesn’t look like the rest of the country. People are always skeptical expanding to the whole U.S. the findings from a Massachusetts experiment.”