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Massachusetts

Massachusetts had the lowest rate of uninsured people in the country as of 2019 with 3%, per a report from the Kaiser Family Foundation (KFF). Still, that amounts to over 202,000 people without health insurance. When KFF looked at the uninsured tally again this year, the nonprofit found that of the people still without coverage, around half (104,200) would qualify for a marketplace plan.

Marketplace coverage is comprehensive health insurance, meeting all the rules and regulations of the Affordable Care Act (ACA). The ACA requires marketplace plans to cover pre-existing conditions and 10 essential health benefits. It also established advance premium tax credits, also known as subsidies, to help people afford health insurance.

These tax credits are available to people with incomes of 100% to 400% of the federal poverty level. In practice, that means most people qualify for some level of assistance.

Kaiser Family Foundation found that of the marketplace-eligible people in Massachusetts without health insurance in 2021, about 8% of them could get a bronze plan for free (no monthly premium at all).

Massachusetts is one of 14 states (plus D.C.) that runs its own health insurance marketplace. If you live in this state, your best bet for a subsidized health plan — meaning one with a discounted premium — is to use your state’s exchange at MAHealthConnector.org. Not everyone qualifies, but it’s worth a check to make sure.

For 2021, KFF calculated the average lowest cost of marketplace coverage in Massachusetts as follows: $277 for a bronze plan, $353 for a silver plan and $419 for a gold plan.

These averages don’t take subsidies into account.

Premium costs and plan availability depend on where you live in the state. There are at least 8 health insurance carriers in Massachusetts offering ACA-compliant plans in 2021. Among them are UnitedHealthcare, BlueCross BlueShield of Massachusetts, BMC HealthNet and Harvard Pilgrim.

One other note: there’s an individual mandate for health insurance in Massachusetts. This means that if you live in Massachusetts, you’re required to have health insurance or pay a penalty, unless you qualify for an exemption.

Sources

Kaiser Family Foundation, “Health Insurance Coverage of the Total Population”
Kaiser Family Foundation, “Marketplace Eligibility Among the Uninsured: Implications for a Broadened Enrollment Period and ACA Outreach” (January 27, 2021)
Kaiser Family Foundation, “Average Marketplace Premiums by Metal Tier, 2018-2021”
Kaiser Family Foundation, “Insurer Participation on the ACA Marketplaces, 2014-2021” (November 23, 2020)

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