Working poor still struggle for coverage in Mass., study finds

Discrepancies in insurance coverage under Massachusetts healthcare reform could serve as a preview of what the Patient Protection and Affordable Care Act could look like for the nation's working poor, according to a study conducted by the New England Research Institutes and published in the Annals of Epidemiology.

Though the study shows a significant increase in healthcare coverage for Massachusetts residents since its 2006 Health Care Reform Act went into effect, gaps in coverage continue to exist among different demographics. The working poor—those earning less than 200% of the federal poverty level—still struggle to get private insurance coverage, unlike their “not-poor” counterparts.

While more than 80% of not-poor residents reported having private insurance coverage, less than half of the working poor were covered under private plans. Instead, they tend to rely on public insurance programs, such as MassHealth, the state's Medicaid program. This is largely because more than half of the working poor included in the study are in industries that traditionally offer part-time or seasonal work, which means they are not often covered under employer-mandated health insurance.

Still, the study did indicate that close to 97% of the approximately 3,050 Boston-area adults surveyed now have some kind of health insurance after enactment of the state law. That's up from 87% before the reform law kicked in. And for those working poor, the number who had no health insurance pre-reform was cut in half after the law's rollout.

“If what has happened with Massachusetts healthcare reform indicates what will occur nationwide with the Affordable Care Act, it will be a historic legislative achievement—expanding quality insurance to millions of Americans with unmet medical needs,” John McKinlay, NERI senior VP and study co-author, said in a news release. “But because of persistent healthcare inequalities, the ACA is obviously a work in progress.”

Follow Rachel Landen on Twitter: @MHrlanden