Although Massachusetts' 2006 health reform initiative led to significant gains in insurance coverage and improvements in access to health care, barriers to obtaining care still exist for some Massachusetts residents, including difficulties finding providers who will see them and high health care costs. This policy brief uses the 2008 and 2009 Massachusetts Health Insurance Survey (MHIS) to examine reported difficulties in obtaining health care for insured residents in the state, focusing on difficulties related to access to providers and unmet need for care because of health care costs.