Massachusetts Health Insurance Survey

2023 Massachusetts
Health Insurance Survey

• Full Report

• Executive Summary
• Health Insurance Coverage and Uninsurance
• Health Care Access and Utilization
• Health Care Affordability
• Behavioral Health

• Detailed Data Tables (Excel)

• Methodology Report
  

• Previous Research
  

New! MHIS Dashboard

New! The Massachusetts Health Insurance Survey (MHIS) provides information on health care coverage, access and affordability trends in the Commonwealth as part of CHIA’s Continuing Study on Insurance Coverage, Underinsurance and Uninsurance. 

The MHIS is a tool used by CHIA, legislators, policymakers, employers, insurers and other stakeholders to track and monitor the experiences of Massachusetts residents in obtaining timely and affordable health care. While national data sources can help monitor some aspects of health care coverage, access and affordability, this survey provides the ability to track issues that are specific to Massachusetts.

The 2023 survey was fielded from April through August 2023 and includes new questions on primary care, telehealth, and behavioral health to capture data on the changing post-pandemic health care landscape.

Key Findings

• Nearly all Massachusetts residents—98.3%—reported having insurance. Uninsured residents in Massachusetts were disproportionately adults aged 19 to 64, males, Hispanic residents, and/or residents with a family income below 300% of the federal poverty level.

• Although 90.9% of residents reported having a primary care provider, 41.2% of residents reported difficulties accessing health care.

• A third (34.3%) of residents reported a telehealth visit in the past 12 months. Among residents who did not have a telehealth visit in the past 12 months, the most frequently reported reasons included a preference for in-person visits (61.7%), telehealth not being right for their health needs (27.8%), and telehealth not being offered by their provider (20.6%).

• Despite near universal health insurance coverage in Massachusetts, nearly half of residents (41.3%) reported that they or their families had an issue affording health care, a burden that is greater for non-Hispanic Black residents (48.7%) and Hispanic residents (58.2%).

• Among the 15.0% of Massachusetts residents who reported paying for their most recent mental health care entirely out-of-pocket, the most frequently reported reasons for doing so were that the provider does not accept any health insurance (36.6%) or their preferred provider did not accept their insurance plan (26.8%).

In response to the COVID-19 pandemic, the 2021 MHIS included new questions to provide data on the impacts of the pandemic on health insurance coverage, health care access and use, and health care affordability, as well as changes in employment, which may affect health insurance coverage, health risk, and ability to pay for health care. The 2021 MHIS was fielded from July through December 2021.

Key Findings

• The 2021 uninsurance rate in Massachusetts was 2.4%, compared to the national rate of 9.2%.
  
  
• Among residents visiting the emergency department (ED) in the past 12 months, over a third (35%) sought care for a non-emergency condition in their most recent ED visit.
  
  
• Two in five residents (41%) said that they had difficulties accessing health care for reasons related to COVID-19 in the past 12 months.
  
  
• Two in five residents (41%) said that they and their families experienced health care affordability issues in the past 12 months, including 60% of residents with moderate family income between 139 and 299% of the Federal Poverty Level. 
  
  
• Over one in four residents reported that their families had unmet health care need due to the COVID-19 pandemic, and Hispanic residents were nearly 1.5 times more likely to report that their families experienced this unmet need compared to White residents (37% vs. 26%).

Massachusetts Foreign-born Residents, Particularly Non-citizens, Are Less Likely to Have Continuous Health Insurance Coverage explores the connection between health insurance coverage rates and immigration and citizenship status

This brief uses data from three consecutive Massachusetts Health Insurance Surveys (2015, 2017, and 2019).

Prior research indicates that citizenship and immigration status are associated with health outcomes and inequities. Correlations between immigration and citizenship status and rates of health insurance coverage may be one contributing factor to such health inequities. As the foreign-born population in Massachusetts continues to increase, improved access to information on disparities in health insurance coverage rates by immigration and citizenship status may help reduce these gaps.