Health Insurance Coverage and Care in Massachusetts

Health Insurance Coverage and Care in Massachusetts, 2015-2019:

A Baseline Assessment of Gaps
by Age, Race and Ethnicity, and Income



CHIA has launched a new series exploring health care equity issues in the Commonwealth, beginning with a baseline assessment of gaps in health insurance coverage, access, utilization, and affordability in the period leading up to the COVID-19 pandemic. Findings from this series are derived from the 2015, 2017, and 2019 Massachusetts Health Insurance Survey (MHIS).

Key Findings from A Baseline Assessment of Gaps by Age, Race and Ethnicity, and Income


    • Among residents with low family incomes, 78.8% of Black residents and 75.0% of Hispanic residents reported having 12 or more months of continuous health insurance coverage, compared with 91.7% of White residents.


    • The racial/ethnic differences in access to health care were most prominent among residents with moderate family income: 39.3% of Hispanic residents reported difficulties accessing care at a doctor’s office or clinic, compared with 29.6% of White residents.


    • Compared to White residents, Black residents were nearly twice as likely to have a potential reliance on the ER for care. Hispanic residents were nearly three times as likely.


    • Residents at the lowest family income level were 2.5 times more likely than those at the highest family income level to rely on the ER for care.


    • About one in three Hispanic residents (32.5%) and over one in four Black residents (27.3%) reported unmet health care needs due to cost, higher than the rate for White residents (22.8%).


    • Within every racial/ethnic group, the highest rates of family medical debt or problems paying family medical bills were for residents in the moderate family income group.


CHIA will continue to monitor developments in these domains for different subpopulations as insights from this report series may help inform efforts to better target interventions for a more equitable health care system in the Commonwealth.