Massachusetts operates the Health Connector, one of the earliest state-based health insurance exchanges in the country, predating the ACA marketplace model. Residents shop for and enroll in plans directly through the Health Connector site.
Massachusetts expanded Medicaid under the ACA, and the state's MassHealth program covers adults up to 138% of the federal poverty level, building on the state's history of near-universal coverage efforts that started with its own individual mandate years before the ACA existed.
Because Massachusetts has such a mature exchange, the Health Connector often includes extra plan options and consumer tools beyond what's typical elsewhere, including ConnectorCare, a state program that adds extra subsidies for lower and middle income residents. Shoppers should check whether they qualify for ConnectorCare before assuming only standard federal subsidies are available.