The Massachusetts Health Care System

The lack of health insurance reached began to become a serious issue in the mid-1990’s reaching a crisis level in the 2000’s. Individuals without insurance turned to emergency rooms across the country to obtain care routine care, turning emergency departments into primary care facilities. In many instances, people who presented at emergency rooms for treatment could not be turned away due to various health and safety regulations; therefore, patients were seen without the ability to pay often leaving the hospitals with millions of dollars in uncollectable debt, subsequently leading to the insolvency of hundreds of hospitals across the United States.

Health System Reform in the United States: Impact of Rising Premiums and Opportunities for System Improvements to Enhance Access to Healthcare Services

In 1986, the Emergency Medical Treatment and Labor Act (EMTALA) was enacted. The federal government enacted the law to provide everyone with access to emergency medical care, even for those unable to pay. EMTALA declared that any individual who enters a “qualifying hospital” is entitled to an “appropriate” medical examination to determine if an “emergency medical condition” is present. The individual cannot be “transferred” until the “emergency medical condition” is “stabilized.” Only if the individual cannot be “stabilized,” an “appropriate transfer” may be performed. Hospitals must accept

The first characteristic of the US health care system is that there is no central governing agency which allows for little integration and coordination. While the government has a great influence on the health care system, the system is mostly controlled through private hands. The system is financed publically and privately creating a variety of payments and delivery unlike centrally controlled healthcare systems in other developed countries. The US system is more complex and less manageable than centrally controlled health care systems, which makes it more expensive. The second characteristic of the US health care system is that it is technology driven and focuses on acute care. With more usage of high technology,

EMTALA is the Emergency Medical Treatment and Labor Act that was developed in 1985 as part of the Title IX of the Consolidated Omnibus Budget Reconciliation Act that went into effect in the year 1986 (Sara Rosenbaum, 2012). EMTALA was developed after an article was published in 1986 that documented how Cook County Hospital in Chicago was receiving patients that were “dumped” there that were unemployed, minorities, and lacked health insurance (Singer, 2014). This problem also occurred in 1983 in Dallas where over 200 patients were transferred between hospitals that were not stable (Singer, 2014). EMTALA is under the direction of the Department of Health and Human Services and was developed to address the needs of Americans

The Emergency Medical Treatment and Active Labor Act (EMTALA) was enacted in 1986 as a part of the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985. EMTALA was enacted to prevent hospitals with Emergency Departments from refusing to treat or transferring patients with emergency medical conditions (EMC) due to an inability to pay for their services. This act also applies to satellite locations whom advertise titles such as “Immediate Care” or “Urgent Care,” and all other facilities where one-third of their patient intake are walk-ins. Several rules and regulations to this act have been established and it has become a very serious piece of legislation and health

The Massachusetts Health Care Act of 2006 was an attempt to give healthcare to all of the residents of Massachusetts. The law mandated that nearly every resident of Massachusetts obtain a minimum level of insurance coverage, provided free health care insurance for residents earning less than 150% of the federal poverty level and mandated employers with more than 10 "full-time" employees to provide healthcare insurance. The law was amended significantly in 2008 and twice in 2010 to make it consistent with the federal Affordable Care Act. Massachusetts ' recent health reform has decreased the number of uninsured, but no study has examined medical bankruptcy rates before and after the reform was implemented. These brief statements say a lot about the health care plan and what it was designed to do. The plan was created by Governor Mitt Romney in Massachusetts beginning in 2005. As a public figure, the people either adored him or despised him. With his plan to control health care in the state of Massachusetts, the success rate was then determined by his popularity throughout the state, with his ability to make the act a form of succession to meet the needs of the people of his state.

Dr. Donald A. Barr in Introduction to US Health Policy discusses the different methods in which states attempt to expand health care coverage throughout his book. In chapter eight, The Uninsured, Barr focusses on one such successful expansion. Massachusetts increases the number of people insured in their state through individual mandate, a term used to describe when a government requires individuals to obtain health care (240). After the success of Massachusetts, the federal government attempted a similar system through a policy called the Affordable Care Act (ACA). How does the ACA compare to the Massachusetts’s policy? Though the ACA was made to reflect the Massachusetts’s individual mandate policy, they also have some key differences.

Since the implementation of the Affordable Care Act (ACA) in 2010, there has been a continuous debate about the effects it will have on the United States economy. Many people argue that expanding insurance coverage for all people will create crippling cost burdens for the economy and taxpayers. While others believe that the ACA will in fact give the economy a much-needed boost. In 2006 as a measure to improve overall healthcare, the state of Massachusetts implemented the Health Care Insurance Reform Act. This paper looks at the positive and negative effects of the Massachusetts Health Care Insurance Reform Act (MHRA). Using a literature review of public health studies ranging from 2009-2012, I argue that there are both positive and negative effects of the Massachusetts Health Care Insurance Reform. While the Massachusetts Reform increased health insurance coverage for all citizens and decreased the number of uninsured citizens accessing emergency rooms, it also did very little to decrease already existing racial, ethnic, and socioeconomic disparities among minorities and whites in the state of Massachusetts. Understanding the Massachusetts Health Care Insurance Reform Act may help in the goal of trying to achieve near-universal healthcare. This paper provides an understanding of the missing pieces in the Massachusetts Health Care Insurance Reform Act and constitutes a starting place from which to understand the Affordable Care Act.

As healthcare costs continue to increase steadily, there has been great focus on methods to reduce charges that contribute to the price of care. Narrowing down to emergency medical services and hospital admissions, many parties have been scrutinizing and crunching numbers, looking for any way to lessen the high expenses. When the realization that the highest healthcare costs occur from an incredibly small number of people (referred to as “super-utilizers” or “super users”) became apparent, the Camden Coalition of Healthcare Providers when into action. The Coalition launched an idea to reform healthcare at the level of initial quality of care given and accessibility of care needed. In turn, the overall cost of healthcare for these patients decreased substantially.

The Emergency Medical Treatment and Active Labor Act (EMTALA) passed in 1986 and it requires hospitals to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay. It further stated Participating

In 2006 the state of Massachusetts wanted to help its millions of citizens who were uninsured. The state legislators as well as the governor put into place a plan to help citizens get insurance. A law was passed to reform insurance in Massachusetts, which was known as Chapter 58 of the Acts of 2006 of the Massachusetts General Court; its long form title is An Act Providing Access to Affordable, Quality, Accountable Health Care.

Because of the EMTALA, therefore, much more than emergency room care is provided regardless of ability to pay” (Menzel, 2011, p. 84).

In Massachusetts, the Massachusetts Health Care Reform Act had a considerable impact on hospitals and the health care system. Most community health centers were benefiting from coverage expansions and safety net hospitals were struggling financially due to the fact that the state put more funding towards insurance subsidies to expand coverage. Academic medical centers (AMC) were able to

Today, admitting to the hospital is so expensive that makes it very difficult to those who do not have insurance to get in when there are sick. This issue becomes so common that retains the concerns of many. For that, the government intervenes by creating institutions such as the Emergency Medical Treatment and Labor Act (EMTALA) and the Consolidated Omnibus reconciliation Act (COBRA) created and passed by the US congress in 1986 to