Press Release

Embargoed Until Contact

April 17, 2013

Sue Ducat
Director of Communications
(301) 841-9962


From Health Affairs


In Massachusetts, Some Low-Income Families Reported A Financial Burden in Paying for Health Insurance


Bethesda, MD -- In six months, open enrollment for the Affordable Care Act's health insurance marketplaces will begin around the country. Massachusetts' experience has proven to be instructive. In 2006, the state created an insurance exchange, called the Commonwealth Health Insurance Connector Authority. The Connector, which began offering unsubsidized commercial insurance products in 2007, now provides an array of options for consumers, including subsidized coverage to people with incomes below 300 percent of the poverty level.


A new study, being released today as a Web First by Health Affairs, surveyed 393 families in unsubsidized Connector plans. It found that 38 percent of surveyed families reported financial burden associated with their health care and 45 percent reported higher-than-expected out-of-pocket costs. This study is one of the first to evaluate the prevalence of and risk factors for financial burden and unexpected costs among families in unsubsidized health insurance exchange plans.


Some Families Who Purchased Health Coverage Through The Massachusetts Connector Wound Up With High Financial Burdens


By Alison A. Galbraith, Anna D. Sinaiko, Stephen B. Soumerai, Dennis Ross-Degnan, M. Maya Dutta-Linn, and Tracy A. Lieu


Galbraith, Soumerai, Ross-Degnan, and Dutta-Linn are affiliated with the Harvard Medical School and the Harvard Pilgrim Health Care Institute in Boston; Sinaiko is with the Harvard School of Public Health; and Lieu is with Kaiser Permanente Northern California in Oakland.


The study will also appear in the May issue of Health Affairs.


To obtain their data, the authors conducted a cross-sectional survey of families enrolled through the Massachusetts Connector in unsubsidized Commonwealth Choice plans from Harvard Pilgrim Health Care, a large nonprofit insurer that has one of the largest market shares among commercial carriers in the Connector. Between April and October 2010 the authors conducted a survey by mail then followed up by phone, studying families both with and without children.


Although exchanges may expand access to coverage, "those with lower incomes, increased health care needs, and more children will be at particular risk after they obtain coverage through exchanges in 2014," the authors conclude. "Given the complexity of health insurance choices and consumers' limited understanding of health insurance benefits, policy makers need to reach out and simplify information to promote optimal plan choices for the people."

About Health Affairs

Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print, with additional Web First papers published periodically and health policy briefs published twice monthly at You can also find the journal on Facebook and Twitter. Read daily perspectives on Health Affairs Blog. Download weekly Narrative Matters podcasts on iTunes.

The full text of each Health Affairs Web First paper is available free of charge to all Web-site visitors for a two-week period following posting, after which it switches to pay-per-view for nonsubscribers. Web First papers are supported in part by a grant from The Commonwealth Fund.