The Massachusetts Health Reform and Children's Health: Can We Achieve Health and Health Care Equity among All Children?

Rosa M. Avila, University of Washington
Norma Coe, University of Washington

In 2006 Massachusetts passed legislation mandating that nearly every resident have health insurance. This study aims to examine whether the Massachusetts Health Reform reduces health and health care disparities among low/moderate-income children (=300% of the FPL) compared to high-income children (>300% FPL). This study is a nonequivalent pretest/posttest comparison group study design of children 0-17 years old using data from the National Survey of Children’s Health. The intervention state is Massachusetts (MA) and the comparison sates are Rhode Island, New Hampshire, and Connecticut. Unadjusted and adjusted estimates are tested in a difference-in-difference-in-difference (DDD) framework. In the preliminary unadjusted analysis, health reform decreased disparities for insurance status by 2.4% and overall health by 6.5%. The preliminary analysis suggests that ending the disparity in insurance coverage does not automatically end health disparities. Additional unadjusted and adjusted analysis on more health outcomes is forthcoming, and might yield different results.