Three-Fourths of Massachusetts Physicians Support Continuing State's Health Reform Law

Three years into implementation, docs rate state's health care system positively.

    • October 21, 2009

A study published in today's New England Journal of Medicine finds that a large majority (70%) of practicing physicians in Massachusetts support health reform three years after its passage in 2006. The study, funded by the Robert Wood Johnson Foundation and the Blue Cross Blue Shield of Massachusetts Foundation, was designed and conducted by researchers at the Harvard School of Public Health (HSPH).

The poll found similar levels of support among primary care doctors and specialists. When asked about the law’s future, 75 percent of physicians say they want to continue the policies—46 percent with some changes and 29 percent as is. When asked what changes they would like to see, physicians most often mentioned issues related to covering more of the uninsured and better controlling costs. Only 13 percent of physicians in the state oppose the health reforms created through the legislation, and just 7 percent believe the policies should be repealed.

“There appears to be broad support among physicians in Massachusetts for the reforms that led to almost all state residents having health coverage,” said Robert Blendon, Sc.D., one of the study’s authors and professor of health policy and political analysis at HSPH. “The findings suggest that it is possible to provide near-universal coverage of the population and have a resulting system that most physicians believe improves care for the uninsured without undermining their ability to provide care to their patients.”

When physicians were questioned about the impact the health reform law has had on their own practice overall, more than half (57%) said there was none; and nearly a quarter (22%) reported that the law had improved their practice. While 50 percent of respondents reported a worsening in conditions at their practice within the past three years, only 11 percent of those queried said the Massachusetts health reform laws were a major reason for the decline. Additionally, 48 percent of physicians cited the law’s success in decreasing the number of uninsured patients treated at their practice. A minority of physicians (35%) cited the law’s negative impact on their practice due to increased administrative burdens.

“Massachusetts’ recent experience in reforming health care provides invaluable insights for federal lawmakers,” said Risa Lavizzo-Mourey, M.D., M.B.A., president and CEO of the Robert Wood Johnson Foundation. “Based on what we have seen in Massachusetts, doctors are supportive of the reforms and their patients appear to be better off. What’s good for doctors and their patients is good for the health of our nation. Leaders in Washington have an opportunity to implement reforms that can bring about similar results nationwide.”

“What is particularly impressive is that on almost every question in which physicians were asked about the impacts of the law on their own practice and patients, a majority reported that it is having either no impact or a positive one,” said Gillian SteelFisher, Ph.D., M.Sc., co-author of the study and research scientist at HSPH.

Physicians rated the Massachusetts health care system much more positively than they did the national health care system, 63 percent to 33 percent. Nearly four in five physicians (79%) believe that the law positively impacted those who were previously uninsured, though overall costs to the state continue to be a concern.

“Whether at the state or national level, health reform is about trade-offs, but the reaction among physicians in Massachusetts has been overwhelmingly positive,” said Anya Rader Wallack, interim president of the Blue Cross Blue Shield of Massachusetts Foundation. “The state now has the lowest proportion of uninsured residents in the nation, and our physicians are looking forward to continuing and improving the health reform efforts already in place. That’s a remarkable achievement.”

The poll of 2,135 Massachusetts physicians was conducted between August 11 and September 15, 2009. The poll had a +/-1.9 percent margin of error.


The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful and timely change. For more than 35 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime.

The mission of the Blue Cross Blue Shield of Massachusetts Foundation is to expand access to health care. Through grants and policy initiatives, the Foundation works with public and private organizations to broaden health coverage and reduce barriers to care. It focuses on developing measurable and sustainable solutions that benefit uninsured, vulnerable and low-income individuals and families in the Commonwealth, and served as a catalyst for the pioneering Massachusetts health care reform law passed in 2006. The Foundation was founded in 2001 with an initial endowment of $55 million from Blue Cross Blue Shield of Massachusetts. The Foundation operates separately from the company and is governed by its own 18-member Board of Directors. It is one of the largest private health philanthropies in New England and in 2007 was awarded the Paul Ylvisaker Award for Public Policy Engagement by the Council on Foundations for its work on health care reform in Massachusetts.

Harvard School of Public Health is dedicated to advancing the public's health through learning, discovery, and communication. More than 400 faculty members are engaged in teaching and training the 1,000-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children's health to quality of care measurement; from health care management to international health and human rights.

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