Two markets for the self-employed
Subsidy-eligible after business expenses → the Massachusetts Health Connector. Above the subsidy line and healthy → private PPO on Cigna, Aetna and PHCS PPO, priced on your health rather than your income. Serious condition → marketplace regardless.
The deduction
Massachusetts has a flat 5% state income tax, so the self-employed health premium deduction helps at both the federal and state level. Self-employed people deduct 100% of premiums above the line on either kind of plan, and can stack HSA contributions on an HSA-eligible plan.
Who we see most in Massachusetts
Realtors, contractors, consultants, drivers, salon owners, and anyone running a business from Boston, Worcester, Springfield and across the state. Massachusetts is one of the most tightly regulated individual markets in the country: the state mandate requires coverage that meets minimum creditable coverage rules, and many non-ACA plans don't. Private options here are narrower than in most states, so the honest answer is usually a careful comparison, not a promise of savings.