More than 200,000 in Massachusetts still without health insurance

The Remaining Uninsured in Massachusetts: Experiences of Individuals Living without Health Insurance Coverage, released Feb. 18, summarizes the findings of a qualitative study by Commonwealth Medicine in which 33 uninsured individuals were interviewed about their experiences of having no health insurance. The report includes the personal stories of five individuals who have experienced the challenges and consequences of being uninsured.

The study was led by Michael Chin, MD, assistant professor of family medicine & community health and health policy associate in the Research and Evaluation Unit of Commonwealth Medicine; and Deborah Gurewich, PhD, assistant professor of family medicine & community health and associate director of the Research and Evaluation Unit. The report was co-authored by Kathy Muhr, MEd, and Heather Posner, MA, of the Research and Evaluation Unit; and Jennifer Rosinski of Marketing Analytics, all of Commonwealth Medicine. Elise LaFlamme, MD, a family physician in Lawrence, and Audrey Gasteier, MS, of the Commonwealth Health Insurance Connector Authority are contributing co-authors.

Massachusetts has the lowest uninsured rate in the nation at about 3 percent, an achievement that is partly the result of the state's 2006 health care reform law, according to the report. In 2006, 8 percent of the state's population was uninsured, but that rate was down to 3 percent in 2008. The remaining uninsured individuals and families in Massachusetts are living with the potential adverse health effects and financial impacts of not having health insurance, the report says.

The study was conducted to gain a better understanding of the reasons that individuals in Massachusetts are uninsured and to inform future strategies that might minimize the barriers to coverage experienced by some residents.

Key findings of the study:

• Individuals are uninsured for a variety of reasons, including the inability to afford health insurance and changes in circumstances that result in the loss of employer-sponsored insurance;

• Most uninsured individuals want health insurance coverage; There are a variety of reasons some people have not applied for health insurance, including not being eligible for employer-sponsored insurance or subsidized health insurance, and not being able to afford health insurance, even if it is subsidized;

• The possibility of penalties for not having health insurance was not a major factor influencing the majority of those who were interviewed;

• Uninsured individuals voiced common themes concerning their experiences in applying for health insurance, including a strong preference for in-person assistance over applying by phone or online; and

• Uninsured individuals had suggestions for how to help people applying for coverage, including making application information more understandable, increasing the availability of in-person assistance, and having enrollment assisters who speak different languages.