Health Insurance Coverage and Care in Massachusetts

A Baseline Assessment
of Gaps by Region

Health Insurance Coverage and Care in Massachusetts, 2015-2019: A Baseline Assessment of Gaps by Region

This report provides a baseline assessment of gaps in health insurance coverage, access, utilization, and affordability in the period leading up to the COVID-19 pandemic across eight regions in Massachusetts. To advance the goal of health care equity in Massachusetts, it is important to examine how geographic differences impact residents’ health insurance coverage and access to care in the Commonwealth.

CHIA’s initial report on health care equity, examining disparities in coverage and care by age, race/ethnicity, and family income groups can be found below.

Key Findings

Although Massachusetts has an overall high rate of health insurance coverage among its residents, regional rates in continuous coverage ranged from 89.4% in Southcoast to 95.3% in Western Massachusetts.
The rates of difficulties accessing care at a doctor’s office or clinic ranged from 25.1% in Metro South to 31.2% in Southcoast.
While the majority of Massachusetts residents reported having visited a doctor in the past 12 months, the regional rates varied from 87.7% in Metro Boston to 91.5% in the Northeast region.
The rates of unmet health care needs due to cost ranged from 21.0% in the Cape and Islands to 31.3% in the Southcoast region.

Health Insurance Coverage and Care in Massachusetts, 2015-2019: A Baseline Assessment of Gaps by Age, Race and Ethnicity, and Income

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

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.