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.

Progress Reports

Each year, the Health Connector publishes a booklet highlighting what we’ve accomplished and who we’ve helped.

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:

Previous Years’ Publications:

Programmatic Audit Reports

Financial Statement Audits

Fiscal Year 2022 (July 1, 2021–June 30, 2022)

Fiscal Year 2021 (July 1, 2020–June 30, 2021)

Fiscal Year 2020 (July 1, 2019–June 30, 2020)

Fiscal Year 2019 (July 1, 2018–June 30, 2019)

Fiscal Year 2018 (July 1, 2017–June 30, 2018)

Fiscal Year 2017 (July 1, 2016–June 30, 2017)

Fiscal Year 2016 (July 1, 2015–June 30, 2016)

Fiscal Year 2015 (July 1, 2014–June 30, 2015)

Fiscal Year 2014 (July 1, 2013–June 30, 2014)