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Closing the Coverage Gaps: Reducing Health Insurance Disparities in Massachusetts

April 27, 2023

Massachusetts has been exemplary in developing health insurance coverage policies to cover its residents. By 2019, the state's uninsurance rate was 3.0 percent, the lowest rate in the nation, representing about 204,000 uninsured residents. While the state's overall uninsured rate at a given point in time is low, more than twice as many people - 503,000, or 7.3 percent of the population - experienced a gap in coverage over the previous twelve months. And importantly, not all groups benefit equally. People who are Black or Hispanic, or who have lower incomes, experience significantly higher rates of uninsurance than the state population overall. As a result, these groups are more likely to face access barriers and financial insecurity associated with being uninsured.The purpose of this report is to begin charting a course toward closing the coverage gaps in Massachusetts, with a particular focus on creating a more racially and ethnically equitable system of coverage. The report and accompanying infographics describe the people in Massachusetts without health insurance and the barriers to coverage they face, including affordability, administrative complexity, and immigration, language, and cultural barriers. It then proposes a menu of policy options that address the specific circumstances in Massachusetts. The proposed options are meant to inform a statewide conversation about the best approaches to closing the remaining coverage gaps in Massachusetts and removing structural barriers that result in racial and ethnic disparities in health insurance coverage.

Health Reform in Massachusetts as of Fall 2010: Getting Ready for the Affordable Care Act & Addressing Affordability

January 27, 2012

Provides updated survey findings about trends since fall 2006 in the insurance coverage, healthcare access and use, costs and affordability, financial difficulties, and attitudes toward state healthcare reform among non-elderly adults in Massachusetts.

Massachusetts Health Reform in 2008: Who Are the Remaining Uninsured Adults?

August 13, 2010

Profiles residents still uninsured after the individual mandate was implemented: young, single, urban, male racial/ethnic minorities and non-citizens with limited English proficiency. Outlines lessons on outreach to those eligible for public coverage.

What Is the Evidence on Health Reform in Massachusetts and How Might the Lessons From Massachusetts Apply to National Health Reform?

June 21, 2010

Examines the gains in health coverage, healthcare access, use, affordability, and quality Massachusetts has seen as a result of health reform, as well as the challenges in sustaining reform as provider capacity remains limited and healthcare costs rise.

Health Reform in Massachusetts: An Update on Insurance Coverage and Support for Reform as of Fall 2008

September 10, 2009

Provides an update on the impact of the state's 2006 health reform on the coverage of 16- to 64-year olds and on support for health reform. Analyzes demographic characteristics, education, work status, and geographic location of the insured and uninsured.

Access to and Affordability of Care in Massachusetts as of Fall 2008: Geographic and Racial/Ethnic Differences

May 28, 2009

Based on a fall 2008 survey, compares access to and affordability of health care, including prescription drugs and dental care, for adults by geography and race/ethnicity. Explores factors behind unmet needs and financial burdens from healthcare costs.

The Impact of Health Reform on Underinsurance in Massachusetts: Do the Insured Have Adequate Protection?

October 16, 2008

Compares the state's uninsurance rate following the 2007 reform to 2006 and national rates, by income. Examines reported problems with paying medical bills to assess the extent to which the "minimum creditable coverage" rule protects against high costs.

Who Gained the Most Under Health Reform in Massachusetts?

October 16, 2008

Outlines key components of the state's 2007 insurance coverage reform and the populations targeted. Compares the reform's impact across population groups, by age, gender, race/ethnicity, health status, employment, and geography.

On the Road to Universal Coverage: Impacts of Reform in Massachusetts at One Year

June 3, 2008

Examines the early results of the state's efforts to achieve near-universal coverage through a combination of Medicaid expansions, subsidized private insurance, insurance market reforms, and required participation by individuals and employers.

Why Do People Lack Health Insurance?

May 1, 2006

Currently, 46 million people or nearly one in five nonelderly adults and children lack health insurance in the United States, an increase of 6 million since 2000. The recent rise in uninsurance has been attributed to a number of factors, including rising health care costs, the economic downturn, an erosion of employer-based insurance, and public program cutbacks. Developing effective strategies for reducing uninsurance requires understanding why people lack insurance coverage. This brief looks at the reasons people report being uninsured overall and by key population subgroups (defined by age, race/ethnicity, health status, and family and employment characteristics). We also examine how those reasons have changed over time.