Mental Health

A new poll by the Harvard School of Public Health and The Boston Globe finds 59% of Massachusetts residents who are aware of the state’s health reform legislation, which was enacted in 2006, support it. A little more than one in four oppose it (28%), and 13% are not sure. The level of public support for the law has declined somewhat in the last year, from 69% saying they support the law in 2008 to 59% in the current poll.

The current number is similar to the 61% found in 2006. Support for the law varied by party affiliation, with 76% of Democrats, 56% of Independents, and just 35% of Republicans saying they support the legislation. The poll was conducted September 14-16, 2009.

Massachusetts is currently facing the impact of a severe recession, state budgetary and fiscal problems, and continued rising health care costs. Despite this difficult environment, the poll found that 79% want the law to continue, with 57% favoring continuing it with some changes and 22% continuing it as is. Only 11% of state residents favored repealing the health reform law. There has been no change in the last year in those supporting repeal of the legislation–12% in 2008 versus 11% in 2009.

“The implication of this poll for the national debate is that it is possible to get continuing public support for a program that leads to nearly everyone in the population having health insurance coverage,” said Robert Blendon, Professor of Health Policy and Political Analysis at the Harvard School of Public Health.

Impact of the law

The principal intent of the Massachusetts legislation was to provide health coverage for nearly all of the state’s residents and, as a result of the widely discussed measure, Massachusetts is the only state where nearly all of the population has health insurance coverage. The poll found that 64% thought the health reform law was successful in reducing the number of uninsured in the state, 22% thought it was not successful, and 14% were unsure.

The poll also asked respondents about the impact of the health reform law on their own health care in terms of quality, costs, and their ability to pay medical bills. On all these measures, about half reported that the law did not have much of an impact on them. Of those who reported an impact, more thought it helped than thought it hurt their quality of care (23% versus 14%), and their ability to pay their medical bills (24% versus 14%). However, on the cost of their own care, the results were not statistically different (24% saying hurt versus 19% helped).

Views about the future

Though the legislation is currently popular, the poll found concerns about the future. The Massachusetts public is divided on whether the state can afford to continue with this law as it currently stands. Forty-three percent said it could not, 40% said it could, and 16% were unsure. Nearly six out of ten (57%) wanted some changes in the law. Those who said this were asked to state in their own words what was the most important change that needed to be made. The responses fell into three categories: lower future costs (30%), increase the coverage and benefits of the current program (23%), and limit the eligibility for subsidies in the future (11%).

“The clear message for state government leaders is that the public wants some action to address the long-term affordability of this program,” said Blendon.

The poll also asked about an issue of recent controversy in the state. To help balance the state budget, the Massachusetts government cut 70% of the funding for subsidized health insurance for certain low-income legal immigrants. Respondents were asked their views about this policy in the future. Forty-three percent said the funding for health insurance coverage for low-income legal immigrants should be fully restored, 28% thought the reduced funding should be left as is, and 19% thought the funding should be entirely eliminated.

Methodology

The Massachusetts Health Reform Poll was conducted by the Harvard School of Public Health and The Boston Globe. Representatives of the two organizations worked closely to develop the survey questionnaire and analyze the results of the poll. The Boston Globe and the Harvard School of Public Health are publishing independent summaries of the poll’s findings, and each organization bears sole responsibility for the work that appears under its name. The Harvard School of Public Health and The Boston Globe paid for the survey and related expenses.

The project team was lead by Robert J. Blendon, a professor who holds joint appointments in the Harvard School of Public Health and the Harvard Kennedy School, and Gideon Gil, Health and Science editor of The Boston Globe. The Harvard research team also included Gillian SteelFisher, John Benson and Kathleen Weldon.

Interviews were conducted with 506 randomly selected Massachusetts state residents, age 18 and older, via telephone by Social Science Research Solutions of Media, Pennsylvania. The interviewing period was September 14-16, 2009. The data were weighted to accurately reflect the demographics of the state’s adult population as described by the U.S. Census.

When interpreting these findings, one should recognize that all surveys are subject to sampling error. Results may differ from what would be obtained if the whole Massachusetts adult population had been interviewed. The size of this error varies with the number of persons surveyed and the magnitude of difference in responses to each question. The sampling error for surveys of 506 respondents is ±5.5 percentage points at the 95% confidence level.