Massachusetts Health Reform: Employers, Lower-Wage Workers and Universal Coverage

Originally published by the Center for Studying Health System Change (HSC), 2007.

Massachusetts Health Reform and Its Impact on Lower-Wage Workers

Massachusetts enacted landmark health reform legislation in 2006 that aimed to achieve near-universal health insurance coverage through a combination of an individual mandate, employer requirements, expanded Medicaid eligibility, and subsidized coverage for low-and moderate-income residents. HSC research examined the implications of the reform for employers and lower-wage workers, a population that had historically been among the most likely to lack health insurance.

The reform required employers with 11 or more workers to make a "fair and reasonable" contribution toward employee health coverage or pay a per-worker assessment. For lower-wage workers, the reform created new pathways to coverage through the Commonwealth Care program, which offered subsidized health plans for residents with incomes up to 300 percent of the federal poverty level. The research explored how employers of lower-wage workers were responding to these requirements and whether the reform was achieving its goal of expanding coverage to the working population that had been most vulnerable to being uninsured. The Massachusetts experience offered lessons for other states and for federal policy makers considering broader health coverage expansion.

Sources and Further Reading

Center for Studying Health System Change, "Massachusetts Health Reform: Employers, Lower-Wage Workers and Universal Coverage" (2007).