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41% of Massachusetts families struggle to afford health care

While the vast majority have insurance, many let health care needs go unmet, a new survey shows.

Many Massachusetts families are letting health care needs go unmet as they struggle with costsLane Turner/Globe Staff

While the vast majority of Massachusetts residents had health insurance during the pandemic, many found health care to be increasingly unaffordable and inaccessible.

According to the Massachusetts Health Insurance Survey, a statewide survey of 5,000 people conducted by the Center for Health Information and Analysis, 2.4 percent of state residents were uninsured in 2021, a low number in line with rates from recent years.

Those numbers are markedly lower than the national uninsured rate, which has hovered closer to 10 percent in the last several years. Yet, health insurance still was inaccessible for some. Nearly half of uninsured respondents said cost was a reason they were uninsured, and 20.6 percent said they didn’t know how to get insurance.


Even for those who have insurance, 41 percent of respondents said they had trouble affording health care.

“Massachusetts continues to be the state with the lowest uninsured rate in the nation,” said Christine Loveridge, manager of research for the Center for Health Information and Analysis. “And yet, two-fifths of residents report they and their families experienced affordability issues in the last 12 months.”

Affordability was a particular challenge for Black residents; 50.8 percent of respondents who identified as non-Hispanic Black said they or their family had problems paying for care. Additionally, 54.9 percent of Hispanic residents reported affordability issues in their families. Comparatively, only 37.9 percent of white residents had affordability challenges for themselves and their families.

Affordability issues were not restricted to those with the lowest incomes. Instead, those with moderate family incomes struggled the most with costs, according to the survey, likely because of eligibility thresholds for government insurance.

According to the report, 31 percent of residents said that they or a family member went without needed health care services in the last 12 months because of cost, with most of these residents reporting unmet dental care or specialist care needs. That’s up from 2019, when 27 percent of residents reported having an unmet health care need because of cost.


“Most dental and vision care are not commonly covered by medical insurance, and specialist care often carries higher copays and coinsurance than general medical care,” the report said. “These types of care may also be costly for the uninsured.”

The pandemic posed unique challenges as well. Nearly 41 percent of respondents said that they had difficulty accessing care over the last 12 months because of the pandemic — because their provider was closed, or that it felt unsafe to travel to or attend a visit with a health care provider.

Simbad Sanchez, from Waltham, has experienced many of the affordability issues firsthand. Uninsured since he left his job to start his own business four years ago, Sanchez initially felt he wouldn’t need insurance because he didn’t smoke or drink.

However, he started to feel something was wrong last year. Needing to see a doctor, he went searching for health insurance, and discovered the robust coverage he once had was too expensive. After attempts to sign up for a cheaper option, he thought he was successful. He later found out he was not enrolled when bills without any insurance deduction started coming in after he saw a doctor.

He will also have to pay out-of-pocket for dental work, after breaking a tooth last week. As for medication, he has been relying on unused pills from his mom to control his blood sugar and has been going without his cholesterol medication.


“My daughter is studying to be an ER doctor. I’m working hard to give her that dream,” he said. “I explained to her, ‘Oh my, what’s happened? Like an orange, [insurance] wants to squeeze, to see how much money they can get.’ ”

Jessica Bartlett can be reached at Follow her @ByJessBartlett.