A number of years ago, Governor Romney told me that under Massachusetts health reform people would go to physicians’ offices for care instead of going to the emergency room. He wasn’t saying that Massachusetts would deliver more care. He was saying that the care would be more appropriate and less expensive.
As it turns out he was wrong. Traffic to the ER in Massachusetts today is higher than it was before the state’s health reform was enacted.
The same argument has been used by President Obama and by supporters of the Affordable Care Act. And now it turns out they are wrong too. As The New York Times reports:
The study, published in the journal Science, compared thousands of low-income people in the Portland area who were randomly selected in a 2008 lottery to get Medicaid coverage with people who entered the lottery but remained uninsured. Those who gained coverage made 40 percent more visits to the emergency room than their uninsured counterparts during their first 18 months with insurance.
This is consistent with our own predictions in an NCPA study done soon after the ACA was passed. Ah, if only they had listened.
Some features of the current Massachusetts law would be prohibited by the ACA. Massachusetts permits insurers to offer discounts to, for example, someone who works in a low-risk industry or participates in a wellness program. The federal law, on the other hand, requires premiums to be based on a single set of factors: family composition, the ages of covered members, tobacco usage, and geographical location. According to state officials, this will cause premiums to rollercoaster, resulting in “extreme premium increases” for many, and a decline for others.
A Pioneer Institute analysis found that 60 percent of small businesses in Massachusetts will experience a rate hike — for some the increase will be over 98 percent — due to this one regulatory change. These same employers are already bracing for the law’s 18 new taxes.
Source: National Review.
That’s from Dr. Ronald Dunlap, president of the Massachusetts Medical Society. He’s commenting on a new survey showing:
The results are similar to last year’s survey that found 50 percent of family doctors and 51 percent of internists open to new patients in Massachusetts.
The average wait time for a non-emergency appointment with a primary care doctor in the latest survey is 39 days for family physicians, an improvement from 45 days last year. But the wait time to see an internist was 50 days, up from 44 days a year ago.
[T]he great bulk of the cost of newly offered coverage will come, not out of profits or hiring, but out of worker cash wages. That is what happened in Massachusetts when “RomneyCare” was implemented. While there was little impact on the overall labor market, there was a striking change for those workers who gained new insurance: they saw wage reductions (relative to the trend) of almost precisely the cost of health insurance to their employers. Adding further evidence for the power of the employer side of the labor market to adjust in the face of an individual as well as an employer mandate, the number of employers offering health insurance actually increased following reform.
By Mark Pauly, et al.
The untold story of the Massachusetts reform is that the small business community has been paying more for health insurance since the commonwealth’s 2006 reform merged sicker individuals into the same risk pool. The legislature has only made matters worse by passing 12 additional mandated benefits since 2006, a cost borne completely by small companies and individuals.
Now the future looks even bleaker for small business. Not only will their highest-in-the-nation premiums go up because of these new [ACA] regulations, but they will be paying on average $8,000 per family, per plan more in taxes over the next ten years.
More from Josh Archambault.