Findings From The 2019 Massachusetts Health Insurance Survey

Transcription

Findingsfrom the 2019MassachusettsHealth InsuranceSurveyApril 2020

Table of ContentsExecutive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6Key Findings for 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Health Insurance Coverage and Uninsurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10Uninsurance at the Time of the Survey for Massachusetts and the Nation, 2008-2019 . . . . . . . . . . . . . . . . . . . . . . . . . 11Uninsurance at the Time of the Survey by Age Group, 2008-2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12Characteristics of the Uninsured, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Reasons for Being Uninsured, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Types of Health Insurance Coverage Overall and by Age Group, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Types of Health Insurance Coverage by Family Income, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16Transitions in Health Insurance Coverage, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17Transitions in Health Insurance Coverage by Age Group, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18Transitions in Health Insurance Coverage by Family Income, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19Transitions in Health Insurance Coverage by Race/Ethnicity, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20Health Care Access and Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21Health Care Access and Use Over the Past 12 Months, 2008-2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23Usual Source of Care by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24Health Care Use by Type of Provider, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25Visit for Preventive Care by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26Visit to a General Doctor by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27CHIACenter for Health Information and AnalysisFindings from the 2019 Massachusetts Health Insurance Survey April 20202

Table of Contents (continued)Visit to a Nurse Practitioner, Physician Assistant, or Midwife by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . 28Visit to a Specialist by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29Visit for Dental Care by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30Prescription Drug Use by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31ED Visits Over the Past 12 Months, 2008-2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32ED Visits by Type, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33ED Visit by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34Multiple ED Visits by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35Among Those with an ED Visit in Past 12 Months, Most Recent ED Visit Was for a Non-EmergencyCondition by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36Reasons for Most Recent Non-Emergency ED Visit, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37Difficulties Accessing Care Over the Past 12 Months, 2008-2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38Difficulties Accessing Care Over the Past 12 Months, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39Difficulties Accessing Care Over the Past 12 Months by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . . . . . 40Difficulties Accessing Care: Unable to Get an Appointment with a Doctor’s Office or ClinicAs Soon As Needed by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41Difficulties Accessing Care: Unable to Get an Appointment with a SpecialistAs Soon As Needed by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42Difficulties Accessing Care: Doctor’s Office or Clinic Not Accepting Insurance Type by Individual Characteristics, 2019 . . . . . . . . 43Difficulties Accessing Care: Doctor’s Office or Clinic Not Accepting New Patients by Individual Characteristics, 2019 . . . . . . . . . 44CHIACenter for Health Information and AnalysisFindings from the 2019 Massachusetts Health Insurance Survey April 20203

Table of Contents (continued)Health Care Affordability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45Affordability Issues among All Massachusetts Residents and Their Families, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . 47Affordability Issues among All Massachusetts Residents and Their Families by Individual Characteristics, 2019 . . . . . . . . . . . . 48Multiple Affordability Issues among All Massachusetts Residents and Their Families by Individual Characteristics, 2019 . . . . . . . . 49Problems Paying Family Medical Bills, 2008-2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50Problems Paying Family Medical Bills by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51Types of Care and Services That Led to Problems Paying Family Medical Bills, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . 52Family Medical Debt by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53Family Medical Debt: Family Insurance Status at the Time All Family Medical Bills Were Incurred, 2019 . . . . . . . . . . . . . . . . 54Family Medical Debt: Among Those with Medical Debt, Amount and Age of Family Medical Bills, 2019 . . . . . . . . . . . . . . . . 55Family Medical Debt: Reasons for Most Recent Family Medical Bills Being Paid Off Over Time, 2019 . . . . . . . . . . . . . . . . . 56Implications of Problems Paying Family Medical Bills and Medical Debt, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57High Family Out-of-Pocket Health Care Spending by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . 58High Share of Family Income on Out-of-Pocket Health Care Spending by Individual Characteristics, 2019 . . . . . . . . . . . . . . . 59Unexpected Medical Bills among Insured Residents by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . . . . . 60Among Insured Residents with an Unexpected Medical Bill, Reasons Why Most Recent Medical Bill Was Unexpected, 2019 . . . . . 61Among Insured Residents, Deductibles by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62Among Privately Insured Residents, High Deductible Health Plans by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . 63Unmet Need for Health Care Due to Cost Overall and by Age Group, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64Unmet Need for Health Care Due to Cost by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65CHIACenter for Health Information and AnalysisFindings from the 2019 Massachusetts Health Insurance Survey April 20204

Table of Contents (continued)Reasons for Unmet Need for Health Care Due to CostAmong Those Who Were Insured at the Time of the Unmet Need, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66Reasons for Unmet Need of Health Care Due to Cost Among Those Who Were Insuredat the Time of the Unmet Need by Age Group, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67Reasons for Unmet Need of Health Care Due to Cost Among Those Who Were Insuredat the Time of the Unmet Need by Family Income, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68Reported Approaches to Lowering Family Health Care Costs, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69Reported Approaches to Lowering Family Health Care Costs by Age Group, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . 70Reported Approaches to Lowering Family Health Care Costs by Family Income, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . 71Behavioral Health Care Use and Unmet Need . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72Visit for Behavioral Health Care by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74Visit for Behavioral Health Care by Health Statuses, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75Most Recent ED Visit Was Related to a Behavioral Health Condition by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . 76Most Recent ED Visit Was Related to a Behavioral Health Condition by Health Statuses, 2019 . . . . . . . . . . . . . . . . . . . . 77Unmet Need for Behavioral Health Care Due to Cost by Individual Characteristics, 2019 . . . . . . . . . . . . . . . . . . . . . . . . 78Unmet Need for Behavioral Health Care Due to Cost by Health Statuses, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79About the MHIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82CHIACenter for Health Information and AnalysisFindings from the 2019 Massachusetts Health Insurance Survey April 20205

Executive SummaryThe Massachusetts Health Insurance Survey (MHIS)in the past 12 months (95%). However, access andis a statewide, population-based survey of non-affordability issues persist across all groups regardlessinstitutionalized Massachusetts residents. It is part of theof age, gender, race, health status, or family income.Continuing Program of Study on Insurance Coverage,One-third of residents of the Commonwealth reportedUnderinsurance and Uninsurance at the Center fordifficulty accessing needed care over the past 12 months.Health Information and Analysis (CHIA). The MHISMany residents also experienced health care affordabilityprovides information on health insurance coverage,problems, including 48% of all residents and 68% of thosehealth care access and use, and health care affordabilitywith family income at or below 138% of the FPL (Federalin the Commonwealth. MHIS data are used by CHIA,Poverty Level). These affordability issues include problemslegislators, other policymakers, employers, insurers, andpaying family medical bills, family medical debt, paying aother stakeholders to track and monitor the experienceshigh share of family income on out-of-pocket health careof Massachusetts residents in obtaining timely andexpenses, and unmet health care needs due to cost.affordable health care.CHIAHealth Insurance Coverage and UninsuranceMassachusetts continues to have a very low uninsuranceMassachusetts’s uninsurance rate remained much lowerrate (2.9%). Nearly all residents have a usual source ofthan the nation in 2019, with fewer than three percentcare that is not the emergency department (91%), andof Massachusetts residents uninsured at the time of themost had a health care visit with at least one providersurvey. This compares to 9.4% uninsured nationally inCenter for Health Information and AnalysisFindings from the 2019 Massachusetts Health Insurance Survey April 20206

2018, based on the most recently available estimatestheir most recent visit. Thus, while nearly all residents arefrom the National Health Interview Survey (NHIS). Thereceiving some health care, these results suggest someuninsured in Massachusetts were more likely than thepersistent barriers to obtaining health care services ingeneral Massachusetts population to be non-elderlyMassachusetts.adults, male, Hispanic, and have family income below300% of FPL. Employer-sponsored coverage remainedthe dominant source of coverage in Massachusetts,accounting for over 60% of all insured persons in 2019.Furthermore, the vast majority of Massachusetts residentshad continuous coverage in 2019, with more than nine in10 residents reporting health insurance coverage for all ofthe past 12 months.Despite the high rate of health insurance coverage inMassachusetts, health care costs remained a concernfor many residents in 2019. Nearly half of Massachusettsresidents (48%) reported affordability issues over thepast 12 months. This included problems paying familymedical bills (16%), family medical debt (17%), spending ahigh share of family income on out-of-pocket health careexpenses (15%), or having unmet need for health care dueHealth Care Access and UseAs in previous years, in 2019, nearly all Massachusettsresidents were able to access and use at least somehealth care services over the past 12 months. Nearly allMassachusetts residents reported having a usual sourceof health care (91%) and a visit to a health care provider inthe past 12 months (95%). Nonetheless, almost one-thirdof residents reported difficulties accessing care in 2019,with more than one in six residents reporting difficultiesCHIAHealth Care Affordabilityto costs (27%). The finding that more than one in sevenresidents reported spending a high share of income onout-of-pocket costs suggests that at least some residentsand their families were underinsured in 2019. Further,more than one-third of residents who were insured forall of the past 12 months had unexpected medical bills,defined as receiving a family medical bill where the healthplan paid much less than expected or nothing at all.getting an appointment with a doctor’s office or clinic asBehavioral Health Care Use and Unmet Needsoon as needed. More than one in four residents visitedOne in six Massachusetts residents reported having aan emergency department (ED), 34% of whom reportedvisit for behavioral health care in the past 12 monthsseeking care in the ED for a non-emergency condition at(17%) and 4% of residents reported an unmet need forCenter for Health Information and AnalysisFindings from the 2019 Massachusetts Health Insurance Survey April 20207

behavioral health care due to cost. Populations withversus 3%). Residents below age 65 and those in fair orhigher health care needs reported much higher rates ofpoor physical or mental health were more likely to reportbehavioral health care utilization. For example, residentsan unmet need for behavioral health care due to costs.who reported fair or poor mental health status were fourUnmet need for behavioral health care due to cost wastimes as likely as those in better mental health to visit areported both by those who used behavioral health carehealth care provider in the past 12 months (53% versusin the past 12 months and those who did not, suggesting12%), and six times as likely to report that their mostcost-related gaps in care for both populations. nrecent ED visit was for a behavioral health condition (15%CHIACenter for Health Information and AnalysisFindings from the 2019 Massachusetts Health Insurance Survey April 20208

2.9%92%Key Findingsuninsurance rate inMassachusettsresidents had health insurancecoverage for the full year32%34%48%residents had difficultiesaccessing health careresidents visiting the emergencydepartment sought care fora non-emergency conditionresidents had health careaffordability issues37%residents insured all year hadunexpected medical bills27%residents had an unmet needfor health care due to cost17%residents reported having avisit for behavioral health care

Health Insurance Coverageand UninsuranceOne of the primary goals of the Massachusetts HealthKey Findings:Insurance Survey (MHIS) is to track health insurancecoverage for Massachusetts residents. The MHIS collectsinformation on insurance status for multiple reference periods,including at the time of the survey and during the past sixmonths, 12 months, two years, and five years. The MHISalso has specific questions about coverage transitions andperiods of uninsurance that capture residents’ churn—that is,transitions between periods of coverage and uninsurance. As in prior years, the uninsurance rate inMassachusetts in 2019, at 2.9%, remained lowcompared to the nation, which was 9.4% in 2018. The uninsured were more likely than the generalpopulation to be non-elderly adults, male, Hispanic,and have family income below 300% of the FederalPoverty Level (FPL). The majority of residents had continuous coverageAdditionally, the MHIS collects information on types ofin 2019, with more than nine in 10 residents havinghealth insurance coverage. Residents who reported moreinsurance coverage for all of the past 12 months.than one type of health insurance were assigned to asingle coverage type according to the following hierarchy:employer-sponsored insurance, Medicare, MassHealthor ConnectorCare, private non-group coverage such as Employer-sponsored coverage remained the dominantsource of coverage in Massachusetts, accounting formore than 60% of all insured residents in 2019. nindividual purchases of Health Connector plans, and otheror unspecified coverage.CHIACenter for Health Information and AnalysisFindings from the 2019 Massachusetts Health Insurance Survey April 202010

Health InsuranceCoverage andUninsuranceUninsurance in Massachusettsremained low in 2019, with only 2.9%Uninsurance at the Time of the Survey for Massachusettsand the Nation, 2008-201925%of the residents uninsured at the timeof the survey. The uninsurance ratein Massachusetts decreased from3.7% in 2017 to 2.9% in 2019, but this20%change was not statistically significant.The Massachusetts uninsurancerate continues to be well below the15%14.715.416.015.114.714.4national rate based on estimates from11.5the National Health Interview Survey(NHIS).The reduction in the uninsurance rate9.210%9.08.89.4nationally between 2013 and 2015reflects in part the implementationof key components of the AffordableCare Act (ACA), the national reform5%legislation that builds on the 2006Massachusetts health care sing health care costs and thereduction or elimination of someaspects of the ACA have d to the rising uninsurancerate nationally in recent years.MA (MHIS 2008-2011)MA (MHIS 2014-2019)US (NHIS 2008-2018)Notes: Due to changes in the MHIS survey design in 2014, the estimates for 2008–2011 are not directly comparable to later years. The 2019 survey design was expanded to include an address-based sample(ABS) in addition to the random-digit-dial (RDD) telephone sample used from 2014–2017. Though estimates between the 2019 ABS and RDD are similar, caution should be used when interpreting trends (denotedby the dotted line). Please see methodology report for more information.Source: 2008-2011, 2014, 2015, 2017, and 2019 Massachusetts Health Insurance Survey (MHIS) for Massachusetts estimates. 2008-2018 National Health Interview Survey (NHIS) for national estimates.CHIACenter for Health Information and AnalysisFindings from the 2019 Massachusetts Health Insurance Survey April 202011

Health InsuranceCoverage andUninsuranceNon-elderly adults in MassachusettsUninsurance at the Time of the Survey by Age Group, 2008-201910%had the highest uninsurance rate in2019 (4.1%), which was still well belowthe national rate for non-elderly adultsbased on the 2018 NHIS (13.3%;8%data not shown). The decreases inuninsurance rates by age group inbetween 2017 and 2019 were notstatistically 00.8201420152.11.60.32016Non-elderly adults (19 to 64)(MHIS 2008-2011)Non-elderly adults (19 to 64)(MHIS 2014-2019)Children (0 to 18)(MHIS 2008-2011)Children (0 to 18)(MHIS 2014-2019)Elderly adults (65 and older)(MHIS 2008-2011)Elderly adults (65 and older)(MHIS 2014-2019)20170.120182019Notes: Due to changes in the MHIS survey design in 2014, the estimates for 2008–2011 are not directly comparable to later years. The 2019 survey design was expanded to include an address-based sample(ABS) in addition to the random-digit-dial (RDD) telephone sample used from 2014–2017. Though estimates between the 2019 ABS and RDD are similar, caution should be used when interpreting trends (denotedby the dotted line). Please see methodology report for more information.Source: 2008-2011, 2014, 2015, 2017, and 2019 Massachusetts Health Insurance SurveyCHIACenter for Health Information and AnalysisFindings from the 2019 Massachusetts Health Insurance Survey April 202012

Health InsuranceCoverage andUninsuranceCharacteristics of the Uninsured, 2019The majority of the uninsured inMassachusetts in 2019 were non-CharacteristicAmong the uninsured residents,percent with the characteristicAmong all residents,percent with the characteristicand had family income below 300%Aged ily income below 300%of the FPL72.5%37.6%elderly adults (aged 19 to 64), male,of the FPL. The uninsured were alsodisproportionately Hispanic. The familyincome of the uninsured suggest thatmany may be eligible for public healthinsurance coverage or subsidizedcoverage through the MassachusettsHealth Connector.Notes: The sample of uninsured residents was defined as those without insurance at the time of the survey. Given the low uninsurance rate in Massachusetts, the sample size for this analysis is small, at 81individuals. FPL Federal Poverty Level.Source: 2019 Massachusetts Health Insurance SurveyCHIACenter for Health Information and AnalysisFindings from the 2019 Massachusetts Health Insurance Survey April 202013

Health InsuranceCoverage andUninsuranceReasons for Being Uninsured, 2019In 2019, the most commonly reported80.4%Cost is too highreasons for Massachusetts residentsbeing uninsured were all related to costand availability of coverage. About47.0%Lost eligibility for MassHealthfour in five (80.4%) uninsured residentsreported the cost of coverage was toohigh, followed by losing eligibility for44.5%Employer coverage not availableMassHealth (47.0%) and employercoverage not being available (44.5%).33.2%Lost job or changed employers28.7%Don't know how to get insurance16.4%Don't need insurance5.2%Traded for another benefit/higher pay2.6%Divorce, separation, death20.4%Some other reason0%20%40%60%80%100%Notes: The categories listed above are not mutually exclusive. Respondents were asked to select all applicable options. The sample for this analysis was defined as those without insurance at the time of thesurvey. Given the low uninsurance rate in Massachusetts, the sample size for this analysis is small, at 81 individuals.Source: 2019 Massachusetts Health Insurance SurveyCHIACenter for Health Information and AnalysisFindings from the 2019 Massachusetts Health Insurance Survey April 202014

Health InsuranceCoverage andUninsuranceTypes of Health Insurance Coverage Overall and by Age Group, 2019Employer-sponsored insuranceAll insuredresidentsChildren(0-18) Non-elderly adults(19-64)Elderly adults(65 and older)Employer-sponsored %*58.7%*MassHealth or ConnectorCare15.9%21.3%17.9%1.9%*Private, non-group coverage,including Health Connector Plans3.1%3.2%3.8%0.2%*(ESI) was the most common type ofCharacteristiccoverage in Massachusetts in 2019,health insurance for residents withat 64.4%. Another three in 10 insuredresidents were covered by Medicare,MassHealth, or ConnectorCare.Private non-group and other coveragetypes were relatively rare, coveringfewer than 5% of insured residents.ESI was the most common coveragetype for children and non-elderlyadults, while elderly adults were mostlikely to be covered by Medicarefollowed by ESI. Elderly adults with ESIwere also likely to have Medicare.Notes: Residents were assigned a single coverage type based on the following hierarchy: employer-sponsored insurance; Medicare; MassHealth or ConnectorCare; private non-group coverage including HealthConnector Plans; and other coverage. Employer-sponsored insurance includes all those with coverage from a workplace or union, regardless of enrollment in other coverage types. Medicare coverage estimatesinclude Railroad Retirement board coverage and those dually eligible for Medicare and MassHealth. Estimates do not sum to 100% due to rounding and because “Other coverage or coverage type unknown” isnot shown. Reference group for age group estimates*Difference from estimate for “Children (0-18)” is statistically significant at the 5% level.Source: 2019 Massachusetts Health Insurance SurveyCHIACenter for Health Information and AnalysisFindings from the 2019 Massachusetts Health Insurance Survey April 202015

Health InsuranceCoverage andUninsuranceTypes of Health Insurance Coverage by Family Income, 2019In 2019, insured Massachusetts22.6%residents with family income at or43.5%*Employer sponsored insurancebelow 138% of the FPL were less73.6%*likely than all other income groups toreport employer-sponsored insurance84.6%*coverage. As would be expected,public coverage was most commonlyreported among residents with familyMedicareincome at or below 138% of the FPL.11.1%*7.7%*MassHealth or .8%3.9%2.6%Private non group coverageincluding Health Connector Plans0%20%At or below138% ofthe FPL 40%Between139 and 299%of the FPL60%Between300 and 399%of the FPL80%100%At or above400% ofthe FPLNotes: Residents were assigned a single coverage type based on the following hierarchy: employer-sponsored insurance; Medicare; MassHealth or ConnectorCare; private non-group coverage including HealthConnector Plans; and other coverage or coverage type unknown. Employer-sponsored insurance includes all those with coverage from a workplace or union, regardless of enrollment in other coverage types.Medicare coverage estimates include Railroad Retirement board coverage and those dually eligible for Medicare and MassHealth. Estimates do not sum to 100% due to rounding and because “Other coverage orcoverage type unknown” is not shown. Reference group*Difference from estimate for “At or below 138% of the FPL” is statistically significant at the 5% level.Source: 2019 Massachusetts Health Insurance SurveyCHIACenter for Health Informatio

300% of FPL Employer-sponsored coverage remained the dominant source of coverage in Massachusetts, accounting for over 60% of all insured persons in 2019 Furthermore, the vast majority of Massachusetts residents had continuous coverage in 2019, with more than nine in 10 residents reporting health insurance coverage for all of