Study: Health Insurance Cost Split Proportionately

A new study affirms one of the key principles of Massachusetts's landmark health care reform law: employers, individuals and the government are proportionately sharing the burden of paying for insurance.

Overall spending on health care increased 23 percent after the new law's passage, from $20.8 billion in 2005 to $25.5 billion in 2007. But the spending distribution among the three groups hardly changed.

The report, released by the Blue Cross Blue Shield of Massachusetts Foundation, found that employers paid about half of the total health care spending in both 2005 and 2007. Individuals and the state and federal government nearly split the other half.

"The message here is the stability of the sharing, at least in the early stages," said Robert Seifert, one of the authors of the report. Seifert participated in a Monday panel discussing the findings, which he described as encouraging.

"Part of it is that things this big don't change that fast," Seifert continued, "but I think it's largely due to the fact we didn't take the whole thing apart and put something new in place."

All told, the report said employers represented about half of spending in 2005 and in 2007. The percentage of individual contributions stayed the same at 25 percent. Government contribution rates also stayed level at 27 percent.

Seifert said even without the health care expansion, health care costs would have likely been 60 percent of the actual total increase - about $2.8 billion - because of increased medical costs.

According to the report, the largest spending increase by individuals was for private coverage purchased by residents without access to employer coverage and ineligible for a public program. But that total, which rose from $251 million in 2005 to $337 million in 2007, represented only 5 percent of individual spending. The largest share was worker-paid premiums for employer health plans.

Government contribution grew slightly faster than the other two groups because of Commonwealth Care, a new public program. Individuals also paid more for uncovered services as the government's payments for those services declined sharply, the report said.

Amy Whitcomb Slemmer, executive director of the advocacy group Health Care For All, said the findings show the success of the Massachusetts system.

"There was a worry that employers would stop providing coverage because the public plan was available and that's just not the case," said Whitcomb Slemmer, who was also a member of the panel. "It's a sign of success for Massachusetts."

Nearly three years after the passage of the law that mandates health insurance for virtually all Massachusetts residents, state officials estimate about 97 percent of the population is covered. And the study said since the law was implemented, at least 442,000 previously uninsured people have enrolled in private or state-subsidized plans.

"It does bear future monitoring overall, since things may change," Seifert said. "But so far, so good."