The Impact of Health Reform on Underinsurance in Massachusetts

In 2007, Massachusetts enacted health reform that mandated health insurance coverage and set a standard for “minimum creditable coverage” (MCC). Given the coverage mandate, underinsurance became a salient issue. Underinsurance occurs when an individual’s health insurance does not sufficiently cover health care costs.

This policy brief examined the adequacy of coverage in Massachusetts after health reform. Interviews were conducted with adults between 18 and 64 in fall 2006, before health reform implementation, and fall 2007, one year after initiation of reform.

Key Findings:                       

  • In fall 2006, between 4 to 7 percent of adults in Massachusetts were underinsured as defined as using more than 5 or 10 percent of family income on out-of-pocket health care costs. In 2007, the percentage of underinsurance decreased by close to 2 percent when both definitions of underinsurance were used.
  • Underinsurance decreased the most for adults who were lower income (between 5–5.5%) and had health problems (approximately 3%).
  • After health reform, adults who were not underinsured and insured all year increased by 5 percent with increases of 13 percent and 7 percent for lower income adults and adults with health problems.

Health reform in Massachusetts appears to have increased coverage instead of moving people from uninsured to underinsured status.