May 4, 2021 – This past week, the Massachusetts Center for Health Information and Analysis (CHIA) released two new reports on the high costs of health care. These reports are another reminder that consumer affordability is one of the leading health care challenges in Massachusetts. While we are proud that our state has the highest rate of insurance coverage in the country, these reports demonstrate that having health insurance coverage in Massachusetts does not guarantee affordable or accessible health care.

The CHIA report on unmet health care needs showed that a quarter of Massachusetts residents with insurance had to forgo medical care and had unmet medical needs due to the cost of care. Respondents cited high levels of cost-sharing as a key reason for forgoing care. While 35% of respondents referenced the prohibitive cost of copays and coinsurance, 24% listed the cost of deductibles as the central cause of unmet medical needs. Uncertainty around both costs and coverage were also mentioned by residents. 22% of respondents referred to uncertainty about cost of care, and 18% pointed to uncertainty around coverage of care as top reasons for unmet care. However, the burden of unaffordable care was not equal. Women were more likely to forgo care. Almost one third of adults under 65, lower income families, and those with two or more health conditions, had unmet medical needs due to cost. These types of disparities in financial barriers to care lead to the long-standing health inequities that were laid bare by the pandemic’s devastating impact.

The CHIA report on medical debt showed the crushing impact of this debt on many families, even those with health insurance coverage. The report demonstrated the prevalence and persistence of medical debt in Massachusetts. One in six residents who were insured had medical debt and had to pay off their medical debt over time. This debt was significant. For more than half of these residents, the debt they owed was over $2,000, and for one in ten, the debt was more than $8,000. The reasons for medical debt were also clear— the high consumer cost-sharing that is built into many plans is causing consumers to go into debt. The report found that “81% of insured residents with family medical debt attributed the debt to deductibles, copays and/or coinsurance paid under their health plan.” No family should be saddled with this kind of medical debt when they have insurance coverage.

We can do better in Massachusetts. That is why a strong coalition of consumer advocates, providers, faith-based groups, and small businesses including the Massachusetts Medical Society, the JP Centre/South Main Street, the Coalition for Social Justice, Jewish Alliance for Law and Social Action, the Massachusetts Communities Action Network, and Health Care For All support passage of the More Affordable Care (MAC) Act (HB1247/SB782) introduced by Representative Barber and Senator Keenan. We can build on the systems we have to make health care more affordable for families across the Commonwealth. The MAC Act takes four crucial steps towards health care affordability, accessibility, and equity in Massachusetts. The legislation would: 1) make services and treatments for certain chronic conditions free of charge; 2) establish a program to lower premiums for individuals and small businesses; 3) create a consumer health care benchmark for insurers; and 4) strengthen and bring transparency to our insurance rate review system.

The COVID-19 pandemic has shown the devastating health impacts and loss of lives that result from decades of disparities and widespread barriers to care. We have the opportunity to learn from the painful lessons of this pandemic and build back with a stronger, more equitable health system. Please click here to email or call your state Representative and Senator to ask them to co-sponsor the MAC Act.

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