The Massachusetts Health Insurance Plan

(6/2/09)- According to the results of a study conducted by the Urban Institute, Massachusetts has the country's lowest percentage of uninsured health care residents at 2.6% compared with a national average of 15%, for the year 2008.

The lead researchers for the study were Sharon K. Long and Paul B. Masi. The results of the study were published in a recent edition of the journal Health Affairs. The study also concluded that one in five adults said they had been told in the last 12 months that a doctor or clinic was not accepting new patients or would not see patients with their type of insurance.

(8/28/08)- Recently released figures from a report by the U.S. Census Bureau showed that the number of Americans without health insurance fell for the first time in 20 years- to 45.7 million in 2007 from 47 million in 2006. The rate of people without health insurance declined to 15.3% in 2007, from 15.8% in 2006

The percentage of Americans with private insurance continued to drop, according to that same report, to 67.5% in 2007 from 67.9% in 2006

The main reason for the drop in uninsured was because of government programs, which provided coverage to an additional 2.7 million people in 2007 over 2006.

Medicaid, the state-federal health-insurance program for the poor, added 1.3 million more people, while Medicare, the federal program for the elderly, insured an additional one million.

The government's military health-care programs insured 400,000 more people than the year before.

The number of people on Medicaid rose to 39.6 million in 2007 from 38.3 million in the prior year. Employment based coverage also continued its long decline in 2007, dropping to 59.3% in 2007 from 59.7% in 2006

The number of uninsured in the state of Massachusetts declined by about 317,000 residents, which made up about 24% of the drop in uninsured nationwide, said John Holahan, director of health policy research at the Urban Institute, a Washington think tank.

(7/29/07)- A shortage of primary-care physicians is threatening to undermine Massachusetts' state subsidized Commonwealth Care medical plan for its 550,000 uninsured residents.

According to a study that was just released by the Massachusetts Medical Society 49% of the state's internists are not accepting new patients. 95% of the 270 general practitioners at Boston's top three teaching hospitals have halted new patients. The average wait to get an appointment according to the society is seven weeks.

Median income for primary-care doctors was $162,000 in 2004, making it the lowest type paying doctor according to a study that was conducted by the Medical Group Management Association in Englewood, Colo. Specialists earned a median of $297,00, with cardiologists and radiologists exceeding $400,000.

Under the Massachusetts plan, residents who make between one and three times the poverty level ($48,000 for a family of three) are eligible for coverage. Residents of the state who do not get coverage will pay a penalty on their state taxes, and companies with more than 10 employees will face a fine for each worker to whom they don't provide coverage.

The law officially took effect on July 1, but the state won't impose any penalties until next year.

(6/26/06)- A reader has asked us about nationwide universal health care. Most of our readers are surely aware of the difficulties that occurred when former President Clinton set up a task force to consider a plan during his first term in office. Since then ideas have floated around, but nothing has taken hold on a federal level. An interesting step has been taken by the state of Massachusetts Legislature. They passed a bill that will go into effect in July 2007 mandating that all residents of the state are obligated to buy insurance certified by an entity called a "connector". Consumers can use pretax dollars to buy the insurance

Massachusetts is a state with about 6 1/2 million people covered by some type of health insurance. About 60% are covered by employer health plans, 13% by Medicaid, 12% by Medicare, 4% by individual plans, 1 % by other public programs and 11% are uninsured. The nationwide figure of uninsured is 16%, according to the Kaiser Family Foundation. About 15 percent of New Yorkers, 21 percent of Californians, and 16 percent of Marylanders are uninsured. Some states might well want to wait for more financial help from Washington before making any bolder moves like this one in Massachusetts. .

The plan, approved by both sides of the political spectrum in the State Legislature (though democrats dominate the legislature) provides coverage for everybody and allows the individual to have choice. The plan involves the creation of incentives for employers and individuals to buy insurance from an entity called the Commonwealth Health Insurance Connector mandated to set premiums, sign up insurance companies for the program. A board of private and public representatives will oversee this Authority. On May 25, 2006, the Governor of MA office Press Release stated: "The Romney Administration today announced the appointment of the executive director of the independent authority charged with facilitating the purchase of affordable healthcare insurance products as well as the Governor’s three appointments to the authority’s board.

"Administration and Finance Secretary Thomas Trimarco, who under the law makes the appointment, said today that Jon M. Kingsdale, a 25-year health insurance strategist in the Massachusetts market, has accepted his offer to head the Commonwealth Health Insurance Connector Authority.

"Jon Kingsdale is an experienced health insurance professional whose knowledge and strategic insights will be critical as we work to implement healthcare reform in Massachusetts," said Trimarco. "He has a solid understanding of Medicaid law and healthcare finance, and he has the passion, the skills and the background to lead the start-up effort for this historic undertaking."

The Commonwealth Health Insurance Connector will subsidize people who are ineligible for Medicaid and earn up to 300% of the poverty level, or $28,000 for a single person, and offer affordable plans to people who earn more but are uninsured.

Initially, noncompliance with this program leads to loss of personal tax exemption. Employers with 11 or more employees are to pay $295 per uninsured worker per year. A merger of individual and small group insurance markets that could reduce premiums an estimated 20% is also planned. Part-time workers would not become liable for their health insurance, but could buy into a plan through the Health Insurance Connector.

Karen Davis, President of The Commonwealth Fund, a private Foundation working toward a high performance health system, wrote in her column "Health Insurance For All: What Massachusetts Can Teach Us viewed June 23, 2006): "[w]hat Massachusetts has done potentially holds lessons for every state. One particularly cogent lesson is the manner in which the measure was crafted—via a civil process that successfully brought together numerous players from across the political, business, health care delivery, and policy sectors. The Massachusetts Health Care Reform Plan is grounded in the idea that individuals, employers, and government must share responsibility for health insurance. The plan includes an individual mandate that says that it is every person's responsibility to have coverage and to be able to pay for care when they need it."

If this plan proves feasible, other states may follow and this could lead to a nationwide health insurance program similar to the federal employees’ health program.


Harold Rubin, MS, ABD, CRC, Guest Lecturer
updated June 2, 2009

e-mail: or

Return to Home