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. In 2019, over 280,000 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.
Recent Publications
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
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.
- Health Connector 2013-2015 Strategic Plan-in-Brief (or download an accessible Word document for the visually impaired)
- 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.
- Read the Health Connector’s 2018 Report to the Legislature
- Read the Health Connector’s 2017 Report to the Legislature
- Read the Health Connector’s 2016 Report to the Legislature
- Read the Health Connector’s 2014 & 2015 Report to the Legislature
- Read the Health Connector’s 2013 Report to the Legislature
- Read the Health Connector’s 2012 Report to the Legislature
- Read the Health Connector’s 2011 Report to the Legislature
- Read the Health Connector’s 2010 Report to the Legislature
- Read the Health Connector’s 2009 Report to the Legislature
- Read 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
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 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)