Employers’ Use of Health Insurance Exchanges: Lessons from Massachusetts

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Federal insurance reform is modeled substantially on the successful reforms in Massachusetts, including its version of a health insurance exchange. To learn from both the successes and limitations of Massachusetts’ reforms, this study investigates employers’ use of the Connector, in order to inform states and the federal government about best strategies for design and operation of their new small-group health insurance exchanges and market regulations. Prior research on the Connector has focused mainly on its role in enrolling individuals who, with or without subsidies, purchase non-group coverage. Much less attention has been paid to Massachusetts employers’ use of the Connector — a gap this study was designed to fill. The reasons for low employer use of the Massachusetts Connector so far merits close attention. Although each state’s market structure is distinct, and some trial-and-error is unavoidable, it can be helpful to know more about what has and has not worked so far in Massachusetts to attract employer participation, and why.

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