2009 Winner
Commonwealth of Massachusetts
Innovations in American Government Awards
Innovations in American Government Awards

As the United States continues to debate how best to expand access to health care and reduce costs, Massachusetts is coming close to its goal of securing near-universal health insurance for its residents. In 2006, the state passed a health care reform law requiring that all Massachusetts adults purchase insurance if they can afford it or else pay an income tax penalty. Central to this effort was the creation of the Commonwealth Health Insurance Connector Authority (the Connector). The Connector is an independent, quasi-governmental agency charged with helping businesses, and individuals without access to employer-sponsored insurance, get coverage.

The Connector administers two coverage programs. Commonwealth Care offers full and partial subsidies to low-income adults who cannot afford non-group coverage on their own and are not eligible for employer-sponsored or other government-subsidized insurance. Prior to "CommCare," this population effectively had no coverage options. CommCare borrows from Medicaid and commercial insurance practices to create a new hybrid model of coverage, incorporating a progressively income-scaled schedule of enrollee premiums and copayments.

Commonwealth Choice is an unsubsidized program available to individuals and small businesses. "CommChoice" is a commercial offering designed to increase choice and transparency by fostering managed competition in the insurance marketplace. The Connector awards its Seal of Approval for quality and value to commercial health plans. Residents can then use its virtual gateway to review comparable benefit packages from these plans and enroll online. CommChoice has resulted in lower premiums across all coverage levels. And, since CommChoice's inception, many carriers have developed new, select network plans for the Connector with even lower premiums.

Massachusetts' uninsured rate went down from 10.4 percent in 2006 to only 2.6 percent in 2008. The national average is more than 15 percent. Meanwhile, public support grew from 61 percent to 69 percent during that same period. As the national debate intensifies over this politically contentious issue, many are looking to Massachusetts as a model of health care reform.