Affordability - The Story of the Week

April 13, 2007

A year after legislation intended to make health insurance coverage universal was signed into law, the state entity implementing the landmark measure unanimously voted today to exempt about 60,000 people, or 20 percent of the state's adult uninsured population, from the mandate to purchase insurance.

Connector Authority board members said they reached their best compromise in determining who should not be penalized for being uninsured. The Connector board unanimously approved regulations defining affordability; including a schedule of affordability that determines who would be automatically waived from the mandate based on individuals' income level, age and area of residency. Highlights of the vote include:

• Expansion of the premium-free insurance plans to another 29,000 low-income uninsured people with incomes over 100% of the federal poverty level ($10,210) to 150% of the FPL ($15,315).


• Lower premium contributions for 23,000 residents from $40 to $35 who earn between $15,300 and $20,400 is part of today's vote.


• At the newly reduced Commonwealth Care enrollee conternment-subsidized health insurance program.ribution rates, health insurance will be considered affordable for all 140,000 adults who are eligible for this gov


• An example of what monthly premiums are deemed affordable, based on income under the recommended schedule can be found at www.mass.gov/Qhic/docs/Affordability_pr_4.11.07.doc


• The board voted to approve contracts with six carriers who will offer Commonwealth Choice plans, the state-sponsored unsubsidized products. Originally the Connector planned to enter in a contract with seven carriers but ConnectiCare, which was slated to provide coverage in western Massachusetts, dropped out of the negotiations.


• Separately, on Wednesday the Patrick administration agreed to waive MassHealth premiums for children whose parents are enrolled in Commonwealth Care plans. About 12,000 parents would benefit, according to Connector Authority officials.

The newly adopted regulations are estimated to cost an additional $13 million which will be paid for taking money from the free care pool.

"In the end people learned with each other, talked to each other and fought hard," said board member Celia Wcislo." We come from very different ideological places. We all have things we want to tweak. But we're going to learn and probably make huge mistakes that we'll learn about."

House Speaker Salvatore DiMasi said in a statement: "The determination of affordability at all income levels is a crucial step toward guaranteeing that as many people as possible are insured and keeps us marching steadily toward our goal of providing quality health care that's accessible and affordable to virtually every man, woman and child in the Commonwealth."

In a contrarian view of events the he California-based health care advocacy group Foundation for Taxpayer and Consumer Rights condemned the state's approval of high-deductible health plans, claiming they will prevent people from seeking proper health care. "Massachusetts has moved away from the promise of ´universal´ health coverage at every step as it implements its insurance mandate, and now turns a blind eye to costs that will stop even the ´insured´ from getting needed care."

The Connector plans to hold public hearings on today's approved regulations in May and vote on final regulations in June.

Please feel free to e-mail any questions, comments or concerns. We will continue to update you as more information becomes available.

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