A recent survey reveals that 28% of Massachusetts residents have avoided seeking medical care in the past year due to cost concerns, despite the state maintaining a low uninsured rate of 2.1%. The Massachusetts Health Insurance Survey, released on October 12, 2023, indicates that while the majority of residents have health insurance, affordability and accessibility issues continue to plague many families.
The survey, conducted by the Center for Health Information and Analysis (CHIA) between January and April, involved interviews with 5,365 households and was partly funded by the Blue Cross Blue Shield of Massachusetts Foundation. Nearly 90% of respondents reported having continuous insurance coverage for all household members over the past year, thanks in part to a health reform law passed in 2006 under then-Governor Mitt Romney aimed at achieving universal coverage.
Despite the high coverage rate, approximately 139,741 residents remain uninsured, with a significant number citing the steep costs of healthcare as a barrier. CHIA Executive Director Lauren Peters emphasized the urgent need to address these intertwined challenges of access and affordability, especially in light of potential federal health policy changes.
Many residents with insurance are also facing difficulties. About 46% of those insured hold high-deductible health plans, which require individuals to pay a minimum of $1,650 for individual coverage or $3,300 for family coverage before insurance benefits kick in. As a result, nearly 90% of residents with medical debt reported accruing that debt while insured, with the majority attributing it to deductible payments and copays.
While the percentage of residents struggling to pay medical bills has decreased from 19.6% in 2014 to 13.7% in 2025, those on the lower end of the income spectrum continue to face significant challenges. CHIA noted that residents earning below 139% of the federal poverty level have lower rates of medical debt, likely due to the elimination of copays for MassHealth members in this income bracket.
Moreover, administrative issues are hindering access to care. One in five residents reported difficulties related to healthcare services, with billing disputes being the most common complaint. The survey also highlighted disparities in access to primary care, with 92.4% of white residents having a primary care provider, compared to 87.4% of Black residents and 83.7% of Asian residents.
Despite having a primary care provider, 43% of respondents experienced difficulties accessing care. Many reported challenges related to securing timely appointments, navigating administrative hurdles, and coping with recent office closures. Looking ahead, the Massachusetts Senate is expected to address primary care legislation in 2026, amid calls for reforms to enhance access and reduce wait times for essential services.
The survey also revealed trends in behavioral health care, with over 10% of residents reporting unmet behavioral health needs, primarily due to cost. Interestingly, about 30% of residents visited the emergency department in the past year, with nearly one-third of those visits deemed avoidable had timely care been accessible.
As Massachusetts grapples with these ongoing challenges, health officials and policymakers are urged to focus on the findings of this survey to ensure that residents can access timely and affordable healthcare. The results underscore the importance of addressing affordability and access issues to improve health outcomes for all residents, particularly those in marginalized communities.
