Massachusetts led the nation in 2006 with a comprehensive health care reform law and the establishment of a new Marketplace: the Massachusetts Health Connector, designed to make affordable health insurance available to more people. Over 300,000 Massachusetts residents have health insurance through the Health Connector, and our state has the highest rate of health insurance coverage in the nation. National health reform builds upon the successful example set by Massachusetts. As a result, individuals, families, and small businesses who go to the Health Connector can find even more options, enhanced benefits, and savings.
Publications
Massachusetts Health Connector Strategic Plan 2024–2028
The Massachusetts Health Connector is the country’s first and longest-running state-based health insurance Marketplace, created in 2006 as part of Massachusetts state health reform (Chapter 58 of the Acts of 2006) to provide high-value coverage to individuals and small businesses in the Commonwealth and to serve as a policy and outreach hub for both state and federal health reforms designed to expand and improve health coverage.
Massachusetts Health Connector 2022 Open Enrollment Period: Final Enrollment Results
Building on the Commonwealth’s state health reform efforts and Affordable Care Act’s success, the American Rescue Plan (ARP) has been instrumental in providing premium relief to state residents, driving 253,000 individuals to enroll with the Health Connector during Open Enrollment (OE) for 2022 coverage. Massachusetts’s bedrock of affordability meant the state had a higher coverage rate than other states as the pandemic began and has largely maintained it over the last two years.
Massachusetts Health Connector 2021 Open Enrollment Period: Final Enrollment Results
In 2021, the passage of the American Rescue Plan (ARP) and its significant advancement of affordable health care induced the Health Connector to extend its Open Enrollment (OE) period. Typically, OE is from November 1 through January 23, but in 2021 was extended until July 23 to allow uninsured residents ample opportunity to access ARP-enhanced subsidies, including more robust Advance Premium Tax Credits (APTCs) and special benefits for members reporting unemployment income. The Health Connector enrolled 87,000 new members in Exchange coverage over the course of the 2021 OE period.
Health Care Sharing Ministries Reporting to the Massachusetts Health Connector in 2020 & 2021
September 2021 —A summary of information reported to the Health Connector by health arrangements provided by an established religious organization seeking minimum creditable coverage status for 2020 and 2021.
Data on the Massachusetts Individual Mandate: State Coverage Gains Under the Affordable Care Act
August 2021 —Since 2006, Massachusetts has enforced its state-level individual mandate through the annual income tax filing process where Massachusetts residents are required to report information about their health insurance coverage each year. As a part of its implementation and administration of the Commonwealth’s individual mandate, the Health Connector analyzes detailed information about state residents lacking coverage from health insurance data reported on state income tax returns.
This analysis of tax data from the Massachusetts Department of Revenue (DOR) builds on findings from Tax Years 2013–2015 to provide new insights about coverage gains among uninsured Massachusetts residents as the federal Patient Protection and Affordable Care Act (ACA) was implemented.
Massachusetts Cost Sharing Subsidies in ConnectorCare: Design, Administration, and Impact
August 2021 —Through affordable premiums and cost sharing, the Health Connector’s ConnectorCare program promotes access to care and reduced cost burdens for approximately 193,000 low-to-moderate income Massachusetts residents. As the state Marketplace’s flagship health insurance subsidy program, ConnectorCare offers the Commonwealth’s families comprehensive and high-quality health plan options with affordable premiums and point of care cost sharing.
This technical brief seeks to provide background on the ConnectorCare program and detail the financial structure, administration, cost, and individual and family-level impact of the Massachusetts state-level cost sharing subsidy.
Getting to 100: What we know about the remaining uninsured in Massachusetts
January 2021 —In 2019, less than 3 percent of Massachusetts residents, or roughly 200,000 people, lacked health insurance coverage. The Commonwealth’s highest-in-the-nation rate of coverage can be attributed to innovative state and federal reforms. While together these reforms expanded coverage to nearly half a million Massachusetts residents, in recent years the state’s insured rate has flattened, despite year-round outreach, an enduring state level individual mandate, and state subsidized ConnectorCare plans.
Because being uninsured can be harmful to overall health and undermine economic security, the Health Connector is reinforcing its focus on enrolling the remaining uninsured residents of the Commonwealth. Through a comprehensive review of state and national insurance data, this report highlights what we know about the uninsured in Massachusetts and why they lack coverage.
Massachusetts Health Connector COVID-19 Special Enrollment Period: Final Enrollment Results
September 1, 2020—This brief is designed to provide final data and analysis on supports for state residents to access and maintain their coverage through the duration of the national COVID-19 crisis. The Health Connector established a Special Enrollment Period (SEP) for Massachusetts residents without health insurance coverage or those with coverage that may have become unaffordable. Through the COVID-19 SEP, uninsured residents had a new opportunity to enroll in quality individual/family coverage to access necessary COVID-19 services and protect themselves and their families from health and financial risk.
Massachusetts Health Connector COVID-19 Special Enrollment Period: Results to Date
May 1, 2020—This brief is designed to provide data and analysis (to-date) on supports for state residents to access and maintain their coverage through the duration of the national COVID-19 crisis. The Health Connector’s existing programs paired with new policy strategies aim to expand coverage to the remaining and newly uninsured (particularly those who may be losing job-based health coverage) and protect coverage for current members.
Striving for meaningful choice: Non-group health plans on the Massachusetts Health Connector product shelf
January 2019—This brief is designed to provide data and analysis relative to the breadth of choices offered since the Health Connector’s inception to members purchasing outside the curated plan sets of Commonwealth Care or ConnectorCare. Although subsidized plans represent a larger share of the Health Connector’s membership, there are a limited number of standardized plans serving those members. Through examination of the way in which consumers select a single plan from the dozens available, the Health Connector will continue to refine its approach to plan offerings as well as tailoring decision support tools.
Massachusetts Medicaid Buy-in Study
October 2018—Report on the feasibility of establishing a small employer premium sharing plan for participation in the MassHealth program.
Data on the Individual Mandate
December 2019 — Data on the Massachusetts Individual Mandate: Health Connector Analysis of Department of Revenue Tax Filers Data Tax Years 2013–2015
November 2017 — The Massachusetts Individual Mandate: Design, Administration, and Results
July 2016 —The Blue Cross Blue Shield of Massachusetts Foundation published two reports about the remaining uninsured in Massachusetts co-authored by the Health Connector and the University of Massachusetts Medical School:
- Massachusetts Residents without Health Insurance Coverage: Understanding Those at Risk of Long-Term Uninsurance
- The Remaining Uninsured in Massachusetts: Experiences of Individuals Living Without Health Insurance Coverage
We worked with the Massachusetts Department of Revenue to review enforcement of the requirement to enroll in health coverage.
Leading the Way
Massachusetts has the highest rate of insured residents in the nation, 96.3%. Reform has improved thousands of lives, and has only added 1% in new costs to the state budget, according to an independent analysis.
- NEW Massachusetts Health Connector 2024-2028 Strategic Plan
- Massachusetts Health Connector 2020-2022 Strategic Plan
- Blue Cross Blue Shield of Massachusetts Foundation – Assessing the Results
- Blue Cross Blue Shield of Massachusetts Foundation – Massachusetts Health Reform: A Five-Year Progress Report
- Massachusetts Taxpayers Foundation – An Update on the ‘Budget Buster’ Myth
- Business Community Participation in Health Reform: The Massachusetts Experience, 2012
Reports to the Massachusetts Legislature
These data-rich reports provide a comprehensive review of our work each year.
- View the Health Connector’s 2022 Report to the Legislature
- View the Health Connector’s 2021 Report to the Legislature
- View the Health Connector’s 2020 Report to the Legislature
- View the Health Connector’s 2019 Report to the Legislature
- View the Health Connector’s 2018 Report to the Legislature
- View the Health Connector’s 2017 Report to the Legislature
- View the Health Connector’s 2016 Report to the Legislature
- View the Health Connector’s 2014 & 2015 Report to the Legislature
- View the Health Connector’s 2013 Report to the Legislature
- View the Health Connector’s 2012 Report to the Legislature
- View the Health Connector’s 2011 Report to the Legislature
- View the Health Connector’s 2010 Report to the Legislature
- View the Health Connector’s 2009 Report to the Legislature
- View the Health Connector’s 2008 Report to the Legislature
Progress Reports
Each year, the Health Connector publishes a booklet highlighting what we’ve accomplished and who we’ve helped.
Sharing Lessons Learned
Historical, pre-Affordable Care Act, studies and toolkits examine the Massachusetts health reform model and can inform the work of other states.
- Blue Cross Blue Shield of Massachusetts Foundation – Lessons from the Implementation of Massachusetts Health Care Reform
- Toolkit #1 – Building an Effective Health Insurance Exchange Website
- Toolkit #2 – Implementing a Successful Public Outreach and Marketing Campaign
- Toolkit #3 – Determining Health Benefit Designs
- Toolkit #4 – Mitigating Risk in a State Health Insurance Exchange
- Toolkit #5 – Effective Education, Outreach and Enrollment for Populations Newly Eligible for Health Coverage
- Georgetown University and the Robert Wood Johnson Foundation – The Massachusetts and Utah Health Insurance Exchanges: Lessons Learned
Market-wide Risk Adjustment
The Health Connector administered the market-wide risk adjustment program for the small and non-group merged market for plan years effective January 1, 2014 through December 31, 2016.
Beginning in 2017, the U.S. Department of Health and Human Service began conducting risk adjustment for the Massachusetts market.
The Massachusetts-specific approach to risk adjustment was detailed in the Commonwealth of Massachusetts Notice of Benefit and Payment Parameters 2016 (PDF) released March 27, 2015.
The Technical specifications workbook (MS Excel) is also publicly available:
- Technical specifications workbook—Published November 2015
- Technical specifications workbook—Published April 2013
Previous Years’ Publications:
- Commonwealth of Massachusetts Notice of Benefit and Payment Parameters 2015 (PDF), released April 10, 2014
- Commonwealth of Massachusetts Notice of Benefit and Payment Parameters 2014 (PDF), released April 10, 2013
Programmatic Audit Reports
2022
- Commonwealth Health Insurance Connector Authority Performance Audit of Centers for Medicare and Medicaid Services (CMS) Rule 9957 Requirements
For the Period of July 1, 2021–June 30, 2022—Published April 4, 2023
2021
- Commonwealth Health Insurance Connector Authority Performance Audit of Centers for Medicare and Medicaid Services (CMS) Rule 9957 Requirements
For the Period of July 1, 2020–June 30, 2021—Published May 11, 2022
2020
- Commonwealth Health Insurance Connector Authority Performance Audit of Centers for Medicare and Medicaid Services (CMS) Rule 9957 Requirements
For the Period of July 1, 2019–June 30, 2020—Published May 11, 2022
2019
- Commonwealth Health Insurance Connector Authority Performance Audit of Centers for Medicare and Medicaid Services (CMS) Rule 9957 Requirements
For the Period of July 1, 2018–June 30, 2019—Published April 15, 2020
2018
- Commonwealth Health Insurance Connector Authority Performance Audit of Centers for Medicare and Medicaid Services (CMS) Rule 9957 Requirements
For the Period of July 1, 2017–June 30, 2018—Published April 25, 2019
2017
- Commonwealth Health Insurance Connector Authority Performance Audit of Centers for Medicare and Medicaid Services (CMS) Rule 9957 Requirements
For the Period of July 1, 2016–June 30, 2017—Published June 1, 2018
2016
- Commonwealth Health Insurance Connector Authority Performance Audit of Centers for Medicare and Medicaid Services (CMS) Rule 9957 Requirements
For the Period of July 1, 2015–June 30, 2016—Published July 14, 2017
2015
- Commonwealth Health Insurance Connector Authority Performance Audit of Centers for Medicare and Medicaid Services (CMS) Rule 9957 Requirements
For the Period of January 1–June 30, 2015—Published March 24, 2016
2014
- Commonwealth Health Insurance Connector Authority Performance Audit of Centers for Medicare and Medicaid Services (CMS) Rule 9957 Requirements
For the Year Ended December 31, 2014—Published May 28, 2015
Financial Statement Audits
Fiscal Year 2023 (July 1, 2022–June 30, 2023)
Fiscal Year 2022 (July 1, 2021–June 30, 2022)
- Independent Auditors’ Report on Internal Control Over Financial Reporting and on Compliance and Other Matters Based on an Audit of Financial Statements Performed in Accordance With Government Auditing Standards (PDF)
- Financial Statements and Required Supplementary Information (PDF)
Fiscal Year 2021 (July 1, 2020–June 30, 2021)
- Independent Auditors’ Report on Internal Control Over Financial Reporting and on Compliance and Other Matters Based on an Audit of Financial Statements Performed in Accordance With Government Auditing Standards (PDF)
- Financial Statements and Required Supplementary Information (PDF)
Fiscal Year 2020 (July 1, 2019–June 30, 2020)
- Independent Auditors’ Report on Internal Control Over Financial Reporting and on Compliance and Other Matters Based on an Audit of Financial Statements Performed in Accordance With Government Auditing Standards (PDF)
- Financial Statements and Required Supplementary Information (PDF)
Fiscal Year 2019 (July 1, 2018–June 30, 2019)
- Independent Auditors’ Report on Internal Control Over Financial Reporting and on Compliance and Other Matters Based on an Audit of Financial Statements Performed in Accordance With Government Auditing Standards (PDF)
- Financial Statements and Required Supplementary Information (PDF)
Fiscal Year 2018 (July 1, 2017–June 30, 2018)
- Independent Auditors’ Reports as Required by Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance) and Government Auditing Standards and Related Information (PDF)
- Financial Statements and Required Supplementary Information (PDF)
Fiscal Year 2017 (July 1, 2016–June 30, 2017)
- Independent Auditors’ Reports as Required by Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance) and Government Auditing Standards and Related Information (PDF)
- Financial Statements and Required Supplementary Information (PDF)
Fiscal Year 2016 (July 1, 2015–June 30, 2016)
- Independent Auditors’ Reports as Required by Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance) and Government Auditing Standards and Related Information (PDF)
- Financial Statements and Required Supplementary Information (PDF)
Fiscal Year 2015 (July 1, 2014–June 30, 2015)
- Independent Auditors’ Reports as Required by Office of Management and Budget (OMB) Circular A-133 and Government Auditing Standards and Related Information (PDF)
- Financial Statements and Required Supplementary Information (PDF)
Fiscal Year 2014 (July 1, 2013–June 30, 2014)