The Massachusetts health reform law—the principal piece of which is the requirement for all state residents to have health insurance—has acted as a guinea pig for the rest of country, but a new report shows that it has gained support in the last 2 years. According to a new poll by Harvard School of Public Health and The Boston Globe, support for the 2006-enacted legislation is up 10% since a 2009 poll, rising from 53% to 63% during the 3-year period. Of respondents to the current poll (conducted May 24-26, 2011), 21% opposed it, 6% said they weren’t sure if they support it, and 9% had not heard or read about the law.

When asked if they wanted the law to continue during difficult financial times in the state, 74% said “yes,” with 51% saying they wanted it to continue with some changes and 23% wanting it to continue as is. Just 9% of residents were in favor of repealing the law, which was down 1% from the number of respondents who were in favor of a repeal of the law in the 2009 poll.

At roughly the same time that the aforementioned poll findings were released, study results were printed in the May 13, 2011 online issue of Annals of Emergency Medicine that showed little impact on emergency department (ED) use in the state following implementation of the law. While low-severity ED visits—defined as those that could have been treated by a primary care physician—dropped slightly from 43.8% in 2006 to 41.2% in 2008, the total number of ED visits actually increased at the 11 hospitals included in the study, rising from 424,878 in 2006 to 442,102 in 2008.

Physician’s Weekly wants to know…

• What factors, aside from health insurance, come to play in one’s use of the ED? Why else would people have trouble accessing primary care and thus staying out of the ED for low-severity issues? Is there more to access to care than just being insured?
• Do you think being insured could actually cause one to use the ED more if these people didn’t have to pay out-of-pocket for their visits?
• Do you think access to the information provided in the Annals of Emergency Medicine study would impact Massachusetts residents’ feelings on the law? Why or why not?
• Does the Massachusetts healthcare reform legislation serve as a good model for other states and/or the nation? Why or why not?