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

Publication Date


Document Type



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.

DOI of Published Version



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

Journal/Book/Conference Title

Inquiry : a journal of medical care organization, provision and financing

Related Resources

Link to Article in PubMed