MASSACHUSETTS RESIDENTS ARE largely content with their health care quality and coverage, according to a new CommonWealth Beacon poll. But digging beneath the high level of satisfaction reveals access and cost issues leading to delayed care for residents across the Commonwealth.
One third of residents say they have skipped or delayed seeking care due to cost in the last year, and 25 percent say cost led them to skip or delay seeking care for a dependent. Even getting that care can be a time gamble. A fifth of the state’s residents say they’ve had to wait more than two months for a primary care appointment, and 16 percent have had to wait that long for a specialist.
The sweeping poll on heath care access for CommonWealth Beacon conducted by the MassINC Polling Group – which is partially owned by Commonwealth Beacon’s publisher MassINC – ran from August 11 to 18 and surveyed 1,000 Massachusetts residents with a credibility interval of plus or minus 3.5 percentage points. (Topline | Crosstabs)
It paints a picture of Massachusetts residents mostly happy with their health care coverage, especially when compared with other states, even while large slices of the population report struggling with cost and access.
“There can be two truths,” said Steve Walsh, president and CEO of the Massachusetts Health and Hospital Association. “It can be true that we’re doing well, and it can also be true that we need to do better. And there is no doubt that health care costs are rising. It’s making it harder on employers, including our health care institutions – which are our largest employer in the Commonwealth – so the cost of care impacts their ability to invest in workforce and cutting-edge technologies as well.”
“I don’t necessarily see [the poll results] as an outlier,” he added. “I see it as that we’re getting incredibly good care here, but we need to be more focused on making sure it’s affordable.”
Massachusetts is highly insured – around 2 percent of the state is without some type of insurance coverage – and generally able to access care. A plurality (41 percent) of residents reported an employer plan as their primary source of health insurance, with 23 percent each saying MassHealth/Medicaid or Medicare.
The vast majority of residents say they are either very satisfied (40 percent) or somewhat satisfied (36 percent) with their health insurance, with about the same sentiment for people whose care they manage.
When it comes to the selection of primary care physicians nearby covered by their health insurance, residents again largely report being very (42 percent) or somewhat (33 percent) satisfied, and similarly pleased with their selection of specialists.
Given an open-ended question about how they would describe the health care system in Massachusetts, responses generally reflected three things: it’s excellent, it’s pricey, and it’s slow.
“We have very good health providers in this area,” said a 54-year-old Chicopee woman. “There are just not enough doctors to provide care.”
Respondents ranked Massachusetts highly compared to other states. Some 42 percent of residents said Massachusetts is one of the top states in terms of the quality of health care, which is in line with national rankings from groups like The Commonwealth Fund. The Bay State topped the country in overall rankings of health system performance, which aims to capture affordable health coverage, good-quality care, and the opportunity to live a healthy life. Another 27 percent of residents said Massachusetts care quality was above average, and just 2 percent said it was probably one of the worst states.
These answers grew more positive with income and education level. While just a third of residents making less than $50,000 a year and 27 percent of those with a high school education or less said Massachusetts was one of the top states for health care quality, half of those making over $100,000 annually and 58 percent of those with advanced degrees identified it as a top state.
One possible explanation for that discrepancy, said Rich Parr, vice president of the MassINC Polling Group, is “that quality is uneven and weighted towards those who can afford it.”
Massachusetts has the fourth highest per capita health care spending in the country, according to KFF research. The state Health Policy Commission noted in 2024 that Massachusetts is the state with the second highest family health insurance premiums, including out of pocket spending, with the average annual cost of health care for a family exceeding $29,000.
The Commonwealth Fund, in its national rankings, asks adults if they went without care in the last year due to cost. Its 2025 report using data from 2023 found that 7 percent of adults in Massachusetts went without care in the last year, and only 9 percent of state residents lacked “a usual source of care.”
The MassINC Polling Group poll, however, included those who have delayed and skipped care in the last year – 33 percent of residents overall and 37 percent of residents making less than $75,000 a year. The Health Policy Commission in 2024 reported 40 percent of their survey respondents (and 48 percent of those with income below $50,000) said they are putting off seeing a doctor or going to a hospital, with cost being the major factor.
Yet even as poll respondents decried the price of coverage, 30 percent think that Massachusetts health costs are middle of the pack compared to other states, with 10 percent saying it is one of the worst states and 13 percent one of the top states.
Forty percent hold insurance companies most responsible for the cost of health care, with 16 percent blaming companies that own hospitals and medical practices, and 10 percent saying the costs are due to too many government regulations.
State insurance regulators this year issued regulatory guidance requiring insurance companies to limit the growth of deductibles and co-pays for patients to the rate of inflation for medical care, Gov. Maura Healey’s office noted. They also negotiated a reduction in proposed insurance rates and approved $75.6 million in rebates to over 350,000 people covered by individual and small employer plans in Massachusetts.
“The data bear out that we have a real cost challenge and a real system under stress,” said Doug Howgate, president of the business-backed Massachusetts Taxpayers Foundation. “It can be helpful to compare ourselves to other states, but we also need to take a look at what these impacts mean for our health care system, our state budget.”
The state has to begin identifying issues including but not limited to federal Medicaid cuts that could lead to large swaths of people losing their coverage, he said, because “we know there are going to be additional stressors placed on that system over the next few years.”
On Thursday, Howgate’s organization released an analysis of the looming costs of President Donald Trump’s recent sprawling tax and spend bill. Changes to federal Medicaid policy could reduce MassHealth enrollment by up to 200,000 members and significantly increase burdens on the state’s Health Safety Net. The cost of care for uninsured residents is covered through the safety net, which currently has a funding shortfall of approximately $290 million and reimburses providers at rates far below MassHealth. The changes could increase health safety net demand by up to $510 million, according to the Massachusetts Taxpayers Foundation.
“Removing thousands of MassHealth members from consistent coverage is likely to worsen long-term health outcomes and reduce the largest and most consistent source of funding for community health centers and safety net hospitals already under significant fiscal strain,” the report’s authors wrote.
Residents seem to be feeling those strains. While almost 40 percent told pollsters they waited less than two weeks between scheduling and having a primary care appointment, 12 percent said it took three to four weeks, 12 percent said one to two months, and 20 percent said it took more than two months.
“Healthcare in Massachusetts is difficult to navigate,” said a 40-year-old woman in Freetown. “Not enough PCPs, wait months for the 'soonest’ appointment, and when you get the appointment it’s a turn and burn visit. Typically, the wait in the lobby is longer than the appointment.”
Residents in Southeast Massachusetts reported the longest waits – more than a quarter had to wait more than two months for a primary care appointment. Residents in the Greater Boston area, which boasts the highest density of population and health care facilities, were most likely to report three-week to two-month waits.
“I think the health care system in MA is just ok, not great,” wrote a 42-year-old man from Revere. “In my experience there are always very long waits when scheduling appointments, sometimes many months out. However, these problems probably exist everywhere, and I think MA is likely handling them better than other states.”
State health officials are trying to address the primary care crisis and related spending in part through a dedicated task force under the Health Policy Commission. Healey’s office also highlighted two bills that she signed, which lower health care costs, cap prescription drug co-pays at $25, improve access to primary care, and increase oversight of the health care industry to protect patients and providers.
“Massachusetts has the best health care in the country, and we need to make sure people can afford it,” Healey said in a statement to CommonWealth Beacon. “It’s why we took action to make sure people can continue to get the vaccines they need no matter what happens in Washington, and that insurance will cover it. We also for the first time limited the cost of health care deductibles and co-pays, including capping prescription drug costs at $25.”
For those who needed specialists, 32 percent of residents were able to get an appointment within two weeks, 18 percent between three and four weeks, 15 percent said one to two months, and 16 percent said they had to wait more than two months to have an appointment with a specialist.
The contrast between patient experience and overall satisfaction is a bit of a head-scratcher, notes Parr of the polling group.
“Massachusetts residents seem to have set a pretty low bar when it comes to rating their health insurance and health care experiences,” he said. Majorities are at least somewhat satisfied with their health insurance, despite a third saying they have skipped or delayed care due to cost in the past year, and nearly as many (28 percent) have had a claim denied by their insurance company in the past year, Parr noted.
Residents who have skipped care or had a claim denied “do have a less rosy view” of their insurance, he said, but still, most of these residents are at least somewhat satisfied.
“It may be that Massachusetts’s reputation for health care excellence is driving some of this,” he said. “If residents think they are in one of the top health care states – as most do – perhaps they figure that this is the best service they can expect to get.”
This article first appeared on CommonWealth Beacon and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
