Emerging Federal Policy and Potential Implications for Subsidized Health Insurance Programs in Massachusetts

This chart pack describes the potential threats to subsidized health insurance coverage and financing in Massachusetts under the new federal administration. The goals of this chart pack are to:

  • Provide a high-level overview of MassHealth, the Health Connector, and publicly subsidized health insurance programs in Massachusetts that could be impacted by federal policy changes.
  • Describe the potential changes in federal financing and policy related to Medicaid and subsidized Affordable Care Act Marketplace coverage programs that are likely being considered by the new federal administration.
  • Provide estimates of the potential impacts of these changes (in terms of dollars or lives) for MassHealth and Massachusetts ConnectorCare programs.
  • Identify, to the extent possible, the timing, political hurdles, and implementation vehicles for these potential changes.

On March 20, 2025, the Foundation hosted a webinar that featured a presentation of the chart pack’s content by its authors from Manatt Health. Click here to view a recording of this webinar.

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MassHealth: The Basics – Facts and Trends (October 2024)

This UPDATED (October 2024) edition of the MassHealth: The Basics chart pack provides new data on MassHealth enrollment and spending from the most recent state fiscal years available. The chart pack features a high-level overview of the delivery systems that serve MassHealth members. It also highlights MassHealth’s latest reform efforts, which include initiatives to advance health equity, to expand services and coverage to certain groups, and to improve timely access to behavioral health care.

The chart pack provides comprehensive yet accessible data and explanations of program updates to help policymakers, administrators, advocates, and academics better understand the complex MassHealth program. It is made available in PDF and PowerPoint formats to facilitate its use in presentations.

On November 20, 2024, MMPI hosted a webinar to review facts and data about MassHealth eligibility, benefits and delivery systems, costs, and recent reforms from the latest edition of MassHealth: The Basics. Click here to access a recording of this webinar and a copy of the webinar slides.

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Long-Term Services & Supports (LTSS) in Massachusetts: A Primer on LTSS Coverage, Access, and Affordability

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Long term services and supports (LTSS) are the critical services and supports that people with disabilities and chronic conditions of all ages use to meet their daily living needs, remain independent, and participate in their communities. This primer provides a thorough landscape assessment of LTSS in Massachusetts and serves as a follow-up to the Foundation’s December 2022 report, A Focus on Health Care: Five Key Priorities for the Next Administration, which identified improving access to LTSS as one of five key areas requiring immediate and focused action in Massachusetts.  

This primer is intended to help stakeholders better understand LTSS in Massachusetts: what these services are, who uses them, and how they are delivered and paid for. In summarizing the available data on LTSS payers and programs, utilization and spending, workforce capacity, and quality, the primer highlights the strengths and the challenges in LTSS delivery and access in Massachusetts today.  It also identifies opportunities and considerations for improving access to and quality of LTSS in Massachusetts.

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MassHealth: The Basics – Facts and Trends (October 2023)

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This UPDATED (October 2023) edition of the MassHealth: The Basics chart pack provides new data on MassHealth enrollment and spending from the most recent state fiscal years available. The chart pack features a high-level overview of the delivery systems that serve MassHealth members. It also highlights MassHealth’s latest reform efforts, which include initiatives to advance health equity and to improve timely access to behavioral health care.

The chart pack provides comprehensive yet accessible data and explanations of program updates to help policymakers, administrators, advocates, and academics better understand the complex MassHealth program. It is made available in PDF and PowerPoint formats to facilitate its use in presentations.

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MassHealth: The Basics – Facts and Trends (October 2022)

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This UPDATED (October 2022) edition of the MassHealth: The Basics chart pack provides new data on MassHealth enrollment and spending from the most recent state fiscal years available. The chart pack also features a high-level overview and status update on the state’s delivery system reform efforts, including a summary of the key elements of MassHealth’s latest 1115 demonstration waiver extension that was approved by the Centers for Medicare and Medicaid Services on September 28, 2022.

The chart pack provides comprehensive yet accessible data points and program updates to help policymakers, administrators, advocates, and academics better understand the complex MassHealth program. It is made available in PDF and PowerPoint formats to facilitate its use in presentations.

MMPI recently hosted a webinar to review facts and data about MassHealth eligibility, costs, and recent reforms from the latest edition of MassHealth: The Basics. Click here to access a recording of this webinar and a copy of the webinar slides.

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MassHealth: The Basics – Facts and Trends (October 2020)

This UPDATED (October 2020) edition of the MassHealth: The Basics chart pack provides new data on MassHealth enrollment and spending from the most recent state fiscal years available, as well as a high-level overview and status update on the state’s delivery system reform efforts. The 2020 chart pack features a summary of the many temporary policy and programmatic changes that MassHealth quickly implemented in response to the COVID-19 pandemic.

The chart pack provides comprehensive yet accessible data points and updates on the complex MassHealth program that will be useful to policymakers and administrators, as well as advocates and academics. It is made available in PDF and PowerPoint formats to facilitate its use in presentations.

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MassHealth: The Basics – Facts and Trends (July 2019)

This UPDATED (July 2019) edition of the MassHealth: The Basics chart pack provides new data on MassHealth enrollment and spending from the most recent state fiscal years available, as well as a high-level overview and status update on the state’s delivery system reform efforts. The 2019 chart pack features a summary of the program’s impacts on access to care and health outcomes and new data highlighting the role of MassHealth in supporting the low-income workforce. The chart pack provides comprehensive yet accessible data points and updates on the complex MassHealth program that will be useful to policymakers and administrators, as well as advocates and academics.

Some of the key information from the 2019 chart pack -- which is organized under three sections, Eligibility and Enrollment, Spending and Cost Drivers, and Reforms -- includes:

  • MassHealth enrollment has been relatively stable for the past four years (2015-2018), hovering just above 1.8 million members. Notably:
    • More than 4 in 10 children in Massachusetts are MassHealth members; and
    • More than three quarters of non-elderly MassHealth members live in working families.
  • MassHealth represents a significant portion of the state budget, but the majority of its spending is paid for with federal funding, and spending growth has moderated in recent years as enrollment has leveled off.
    • From 2013-2016, prescription drugs and home- and community-based long-term services and supports (LTSS) were the key drivers behind per-enrollee spending growth in MassHealth.
  • MassHealth’s delivery system reform changes are well underway. Status updates are included on major initiatives:
    • Newly formed Accountable Care Organizations, which began full operation in March 2018, now have over 890,000 MassHealth members enrolled.
    • Launch of the Community Partners and Flexible Services programs to improve integration of behavioral health, LTSS, and social services.
    • Expansion of coverage for outpatient, residential inpatient, and community services to combat the substance use disorder crisis.

The chart pack is made available in PDF and PowerPoint formats to facilitate its use in presentations. A webinar to review this updated chart pack was held on October 29, 2019. A recording of that webinar is available here.

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Faces of MassHealth: Portrait of a Diverse Population

This collection of materials goes beyond the topline statistics often used to characterize those served by MassHealth in order to paint a richer, more meaningful picture of the more than one in four Massachusetts residents enrolled in the program. MassHealth serves our most vulnerable residents across their life spans from infants and children with special needs who gain access to comprehensive health care and support services required to reach their full potential, to the elderly and those living with disabilities who receive community based care that helps them remain in their homes. This detailed set of data and narrative profiles of MassHealth enrollees illustrate many of the life circumstances that create a need for MassHealth, and the various ways that MassHealth impacts individuals and their families. Fully understanding who MassHealth enrollees are and hearing from them about the role MassHealth plays in their lives is critical to informing policy and program development.

This project includes the following components:

  1. A chart pack summarizing the demographic and socioeconomic characteristics of individuals enrolled in MassHealth as of June 2018.
  2. Five journalistic profiles of a diverse set of real MassHealth members.
  3. A databook that provides more detail on the quantitative findings presented in the chart pack.

MassHealth: The Basics (September 2017)

UPDATED (September 2017) chart pack produced by the Massachusetts Medicaid Policy Institute (MMPI), a program of the Blue Cross Blue Shield of Massachusetts Foundation, in partnership with the Center for Health Law and Economics at the University of Massachusetts Medical School. This updated edition includes MassHealth enrollment as of May 2017 and spending from state fiscal year 2016. It is made available in PDF and PowerPoint formats to facilitate its use in presentations.

The Foundation hosted a webinar with author Bob Seifert from the Center for Health Law and Economics, University of Massachusetts Medical School to review the updated summary data on MassHealth enrollment and spending on Wednesday, October 11, 2017. Click here to access the webinar materials.

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UPDATED MassHealth: The Basics (June 2016)

UPDATED (June 2016) chart pack produced by the Massachusetts Medicaid Policy Institute (MMPI), a program of the Blue Cross Blue Shield of Massachusetts Foundation, in partnership with the Center for Health Law and Economics at the University of Massachusetts Medical School. This updated edition includes MassHealth enrollment as of January 2016 and spending from state fiscal year 2015 and is made available in PDF and Power Point formats to facilitate its use in presentations.

The Foundation hosted a webinar with authors Bob Seifert and Carol Gyurina from the Center for Health Law and Economics, University of Massachusetts Medical School to review the updated summary data on MassHealth enrollment and spending on Wednesday, June 29, 2016.

Click here to access the webinar slides.

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