Massachusetts Health Insurance Survey

New! CHIA’s latest research brief explores family medical debt in Massachusetts. Findings show that cost-sharing—especially deductibles—is the most common source of medical debt in the Commonwealth.

Despite near-universal health insurance coverage, more than 1 in 8 Massachusetts residents carries family medical debt. Medical debt poses a persistent affordability challenge and is associated with a wide range of negative consequences, from forgoing medical care to facing food insecurity and housing instability.

Burdened by the Bill: Understanding Medical Debt in Massachusetts combines data from the 2021 and 2023 MHIS. Findings are broken out by sociodemographic characteristics like race and income level.

CHIA has published a research brief examining disparities in the rates of unmet health-related social needs (HRSNs) by race/ethnicity in Massachusetts. Findings show that compared with White residents, Black and Hispanic residents experienced any unmet HRSN more than twice as often even after adjusting for other sociodemographic factors.

Black and Hispanic Residents in Massachusetts Report Higher Rates of Unmet Health-Related Social Needs in Their Families utilizes data from the 2023 MHIS. Additional key findings show that Black and Hispanic residents were:

• Three times as likely to experience food insecurity
• Twice as likely to report financial strain
• Nearly three times as likely to experience housing instability

Racial and ethnic disparities in the rates of unmet HRSNs may contribute to inequities in health care access, utilization, and affordability for Massachusetts residents. These findings can inform targeted policy interventions by focusing on the communities experiencing the highest rates of unmet HRSNs and addressing specific HRSNs, such as food insecurity and housing instability, to improve health outcomes in the Commonwealt

The 2023 Massachusetts Health Insurance Survey (MHIS)

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%).