Center for Health Policy and Research (CHPR) Publications


Premium increases in state health insurance programs: lessons from a case study of the Massachusetts Medicaid buy-in program

UMMS Affiliation

Center for Health Policy and Research; Center for Outcomes Research



Document Type


Medical Subject Headings

Adult; Age Factors; Cost Sharing; Decision Making; Female; Humans; Income; Male; Massachusetts; Medicaid; Middle Aged; Organizational Case Studies; Sex Factors; State Health Plans; United States


Health Services Administration | Health Services Research | Public Health


In March 2003, Massachusetts increased the premiums it charges to most enrollees in its CommonHealth-Working (CH-W) program. This study evaluates the impact of the premium change on disenrollment using a comparison group methodology. The findings indicate that the premium change had only a small, but statistically significant impact on program exits. The CH-W experience differs from other state programs that saw substantial enrollment declines in response to new or increased premiums. This is likely due to factors that make CH-W different from other programs, key of which are administrative procedures intended to minimize disenrollment due to premium nonpayment.

Rights and Permissions

Citation: Gina A. Livermore, Nanette Goodman, Fred Hooven and Lobat Hashemi. (2007). Premium Increases in State Health Insurance Programs: Lessons from a Case Study of the Massachusetts Medicaid Buy-in Program. Inquiry: December 2007, Vol. 44, No. 4, pp. 428-442. doi: 10.5034/inquiryjrnl_44.4.428

Related Resources

Link to Article in PubMed