In April 2006, Massachusetts enacted an ambitious health care reform bill that resulted in significant gains in insurance coverage, access to and use of care, and the affordability of care for the Massachusetts population as a whole and, especially, for lower-income adults. Given the success of health reform in Massachusetts along these dimensions, many of the key features of the Bay State’s initiative were incorporated in national health reform under the 2010 Patient Protection and Affordable Care Act (ACA), including an expansion of public coverage, subsidies for private coverage, a health insurance exchange, insurance market reforms, requirements for employers, and an individual mandate.

There are those who feel that when employers are required to offer health insurance coverage or make payments related to a worker, employers will reduce wages and/or other worker compensation over time to cover those new costs.

This brief, prepared by the Urban Institute on behalf of the Robert Wood Johnson Foundation, examines employment trends in Massachusetts as the state implemented health reform. Researchers found that between 2006 and 2010:

• Declines in private-sector employment were consistent across the states—falling 4.4 percentage points in Massachusetts, compared to 4.8 percentage points, on average, in the rest of the nation.
• The employment ratio in medium-sized firms with 50-499 employees fell by 1.9 percentage points, compared to 2.2 percentage points in the rest of the nation.
• Even when accounting for firm size, industry, and job and worker characteristics, the trends in Massachusetts are similar to those in the nation as a whole.

The authors acknowledge that the recent recession, and the financial crisis that followed, have taken a toll on Massachusetts, as with the rest of the nation. They conclude, however, that there is no indication of negative economic and job consequences relative to other states as a result of health reform.