The Blue Cross Blue Shield of Massachusetts Foundation, on behalf of the Massachusetts Coalition for Coverage and Care, funded a state-level analysis on the impact of the American Health Care Act (AHCA) on Massachusetts focused on 2022, when the law would be fully phased in.

Created by the Urban Institute’s Health Policy Center, this analysis uses state-level cost and coverage data from MassHealth (the state’s Medicaid program), the Massachusetts Health Connector Authority, and the Center for Health Information and Analysis. It is believed to be the first published study of the bill’s impact on an individual state.

Using data from the 2011-2015 five-year file of the American Community Survey, this brief and set of detailed tables provide estimates of local uninsurance rates in Massachusetts. The appendices provide data on the estimates of the number and rate of uninsurance by the following categories: all persons, males, females, children (ages 0-17), non-elderly adults (ages 18-64), and elderly (ages 65+). Each appendix provides these results for a different geographic unit, including large areas such as congressional districts and smaller areas such as school districts.

This chart pack provides an overview of proposals to cap federal Medicaid funding and the considerations for Massachusetts.

The third edition provides a detailed description of key components of Chapter 224, highlighting the progress the state has made in its implementation of the law as of September 2016. This tool is designed for policymakers, advocates, and other stakeholders who wish to track when and how state leaders have addressed policy issues pertaining to Chapter 224.

This year’s release includes two distinct versions of the tracking tool: 1) An abbreviated version that focuses on progress the state has made since August 2015; and 2) A more comprehensive version which documents progress the state has made in implementing the law since its passage in 2012.

This tracking tool is a living document and will be updated annually. If you have any suggested additions or corrections, please email [email protected].

Massachusetts currently has the lowest uninsurance rate in the nation, and as part of the individual mandate to carry health insurance coverage, the state collects detailed information through its tax filing process about the health insurance status of over four million residents. This report analyzes 2011 and 2012 state tax filer data and provides new information about Massachusetts residents that are prone to remaining uninsured over consecutive years. The findings can help inform stakeholders who want to maintain the state’s low uninsurance rate and who strive to lower the number of individuals without health insurance coverage.

Prepared by Michael Chin of the University of Massachusetts Medical School and Audrey Gasteier of the Commonwealth Health Insurance Connector Authority, the analyses in this report represent the first time that tax filer data is being used to quantify the state’s uninsured population over a period of two consecutive calendar years. No other state has such detailed information on its residents’ insurance status.

Since 2001, the Blue Cross Blue Shield of Massachusetts Foundation (the Foundation) has supported community-based organizations, federally qualified health centers, and public agencies through its Connecting Consumers with Care grant program. During the October 2013 through September 2015 grant cycle, 16 organizations across Massachusetts received awards to help low-income and vulnerable consumers enroll in and maintain access to publicly subsidized health insurance coverage, and to help consumers navigate systems of coverage and care with increasing independence. This period coincided with the state’s implementation of key components of the Patient Protection and Affordable Care Act (ACA).

This report includes findings from the evaluation of the 2013-2015 Connecting Consumers with Care grant program. The goals of the evaluation were to 1) assess progress made on select outreach and enrollment measures, 2) describe the practices grantees adopted to reach and enroll consumers in health insurance, and 3) characterize efforts and challenges in defining, promoting, and evaluating consumer self-sufficiency. 

Chapter 58 of the Acts of 2006—“An Act Providing Access To Affordable, Quality, Accountable Health Care”—was signed into law by Governor Mitt Romney on April 12, 2006. The groundbreaking law sought near-universal health care coverage for the residents of Massachusetts by expanding Medicaid, creating a new program of subsidized insurance, enacting changes to the health insurance market, and requiring adults to have health insurance unless an affordable option was not available.

As we mark the occasion of the 10th anniversary of Chapter 58’s enactment, this fact sheet, prepared by Kelly Love and Robert Seifert of the Center for Health Law and Economics at the University of Massachusetts Medical School, presents a summary of the law’s effects, as reported in the many studies that have focused on Massachusetts’ reform. This high-level review summarizes the findings in various categories, including insurance coverage, access to care, health care utilization, and affordability for consumers. The authors also developed a full bibliography as a companion to the fact sheet.

This collection of reports and chart packs is the latest in a series by the Urban Institute analyzing the results of the Massachusetts Health Reform Survey (MHRS) which has been conducted most years since 2006, the year that Commonwealth enacted comprehensive health care reform. The 2015 MHRS, conducted  in the fall of 2015, provides an assessment of the state's efforts to improve the affordability of care and reduce health care spending through the cost containment legislation titled “An Act Improving the Quality of Health Care and Reducing Costs Through Increased Transparency, Efficiency and Innovation” (Chapter 224 of the Acts of 2012). It also assesses the impact of the federal Affordable Care Act (ACA) that began in January 2014.

The 2015 MHRS highlights sustained gains in health insurance coverage since the passage of Massachusetts’ 2006 health care reform law, as well as persistent gaps in health care access and affordability for many of those with insurance coverage. Low-income adults and those with health problems tend to be disproportionately impacted by these gaps. The survey findings are a reminder that the goals of health care reform are not fully achieved by simply reducing the number of people who are uninsured. New strategies are needed to improve access to care and reduce the burden of health care costs for Massachusetts families with insurance coverage, particularly for those made more vulnerable by limited resources and high health care needs.

This year’s results are presented in a variety of publications including:

• Summary
• Full narrative report
• Chart pack
• Infographic

In an effort to expand opportunities for researchers to understand the experience of Massachusetts consumers with accessing and affording health care, the Blue Cross Blue Shield of Massachusetts Foundation will be making available a public use file of the 2015 survey as they did with the previous years’ surveys (i.e., 2006 – 2010, 2012-2013). The 2015 public use files will be available through the Inter-University Consortium for Political and Social Research.

On Tuesday, April 19th, the Foundation hosted a webinar to review key findings from the 2015 Massachusetts Health Reform Survey with author Sharon Long of the Urban Institute. Click here to access the webinar slides.

Although Massachusetts has successfully achieved the lowest rate of uninsurance in the nation, thousands of individuals and families still live with the potential adverse health effects and financial impacts of not having health insurance. In 2015, an estimated 200,000 individuals in Massachusetts did not have health insurance coverage. This report, prepared by a team led by Michael Chin and Deborah Gurewich of the University of Massachusetts Medical School, and Audrey Gasteier of the Commonwealth Health Insurance Connector Authority, summarizes the findings of a qualitative study in which 33 uninsured individuals were interviewed about their experience living without health insurance. Findings from this study can help to better understand the remaining barriers to coverage and inform future strategies aimed at reducing the number of uninsured in the state. The report concludes with the personal stories of five individuals who have experienced first-hand the challenges and consequences of being uninsured.

On November 5, 2015, the Blue Cross Blue Shield of Massachusetts Foundation hosted a symposium for non-governmental users of the Massachusetts All-Payer Claims Database (MA APCD) administered by the Center for Health Information and Analysis (CHIA). This symposium updated users on the current state of the MA APCD, highlighted research that has been made possible as a result of the MA APCD, provided an opportunity to share best practices, and encouraged discussion about future opportunities to enhance the MA APCD in an effort to continuously support data-driven research and policy development in the Massachusetts health care sector. As a follow-up to the event, this summary, prepared by Amy Willis, Business Writing and Editing, highlights key takeaways and recommendations generated from the discussion.

This report summarizes the results of a July 2015 poll conducted by a team led by Robert J. Blendon, Sc.D. of Harvard T.H. Chan School of Public Health. The poll was conducted to assess the perspectives of Massachusetts adults age 65 and over on the issues of affordability, access, and satisfaction with their health care coverage. The results show that while a large majority of seniors are satisfied with the health care they receive as patients, over one-quarter of older adults are dissatisfied with health care costs, and more than one in five report that it has gotten harder to pay for health care services or prescriptions drugs over the past five years. Both concerns are higher among seniors who report poor health or a disability.

There are almost one million seniors in Massachusetts and while most enjoy broad coverage and protection against the cost of many health care services through Medicare, they may also face significant gaps, finding themselves responsible for substantial deductibles, coinsurance and copayments. This report, prepared by Nancy Turnbull and Katherine Heflin of Harvard T.H. Chan School of Public Health, reviews the many private and public coverage options available to seniors to supplement Medicare coverage. Using publicly available data from state and federal sources, this report examines recent trends and issues in private health insurance coverage and public programs to support payment of out-of-pocket costs for Medicare beneficiaries in Massachusetts.

This updated edition of the tracking tool provides a detailed description of key components of Chapter 224, highlighting the progress the state has made in its implementation of the law as of August 2015. This tool is designed for policymakers, advocates, and other stakeholders who wish to track when and how state leaders have addressed policy issues pertaining to Chapter 224.

This tracking tool is a living document and will be updated annually. If you have any suggested additions or corrections, please email [email protected].

In March 2010, President Obama signed The Patient Protection and Affordable Care Act (ACA), which included significant changes impacting health insurance coverage across the United States. Although many elements of the ACA were based on Massachusetts’ health insurance reform, there were still many decisions and activities that Massachusetts needed to address in order to comply with the new federal Medicaid and health insurance marketplace requirements, most of which were required to be effective as of January 2014. This issue brief, prepared by Health Management Associates, focuses on the changes in eligibility, benefits, cost sharing (including premiums), and health plan options available to individuals receiving subsidized insurance in the Commonwealth before and after implementation of the ACA.

The “ Making Health Care Affordable” (MHCA) three-year grant program concluded in 2014. Margaret Houy and Kate Bazinsky of Bailit Health Purchasing, LLC report on the impact of the BCBSMA Foundation’s funding initiative. The goal of MHCA was to fund interventions aimed at containing costs while increasing access and quality of care. Bailit examines how the Foundation’s objectives were met, what factors led to successful program implementation, common barriers faced by grantees, and which programs may have generalizability.