Physicians' views of the Massachusetts Health Care Reform Law--a poll.

10.1056/nejmp0909851 nejm.org e39(1) The Massachusetts Division of Health Care Finance and Policy estimated that only 2.7% of state residents remained uninsured as of spring 2009.2 National policymakers have turned to Massachusetts as a potential model for federal health care reform, and reform proposals recently put forward in Congress include elements from the Massachusetts plan, such as the individual mandate to buy insurance, public-program expansions, and a health insurance exchange. Despite the state’s low percentage of uninsured residents, national reviews of the Massachusetts reform have been mixed, especially in recent months. Although some reports have drawn attention to the state’s insurance gains and indicated that health care costs, though growing, have not exceeded early projections or expectations, others have argued that high costs and some reported problems with access to care should be taken as warnings of the problems the country might face if a similar reform were implemented nationally. For example, Michael Tanner of the Cato Institute has called the Massachusetts reform “unsustainable” because of its “failure to restrain the growth in health care costs” and the fact that it has “set the stage for . . . price controls and explicit rationing.”3 Similarly, a June 24, 2009, post about the Massachusetts reform on the blog of John Boehner of Ohio, the Republican leader in the U.S. House of Representatives, said that “out of control costs” and “rationing” have been consequences of universal coverage in Massachusetts. We know from previous research that the Massachusetts public is favorable toward the state’s legislation,4 but physicians can provide critical insight into how the law is actually functioning and how it has affected access to high-quality health care. In previous studies, Massachusetts physicians have been interviewed about their experiences with and impressions of other reform issues, such as managed care and a potential single-payer health care system, but only one poll to date has asked physicians about Massachusetts health care reform. That online poll, conducted by the American College of Emergency Physicians, focused on the views of 138 emergency docPhysicians’ Views of the Massachusetts Health Care Reform Law — A Poll