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Massachusetts health care — wonky, with a healthy dose of reality

Big Win! Affordable Premiums Will Continue For Low-Income Health Connector Enrollees

Big Win! Affordable Premiums Will Continue For Low-Income Health Connector Enrollees

September 12, 2013

ConnectorCare Results slide

Today, the Health Connector Board voted to award Seals of Approval (SoA) for Qualified Health Plans (QHPs) to be sold on the Health Connector, for coverage effective beginning January 1, 2014 (details in Connector presentation, (pdf)).  Dental plans were also approved. These are the private insurance choices that will be available through the Health Connector starting in October. Coverage will start in January. (As always, we'll have full  details on the Board discussion in an upcoming blog post.)

Under the ACA, many of the lowest-income people in Massachusetts who are now part of the Commonwealth Care program will transition to MassHealth. Most of the rest will receive new federal tax credits and cost sharing assistance to purchase QHPs. Those who are below 300% of the federal poverty level will also get additional state assistance. This has been called the "QHP Wrap," in wonk circles, and will be called ConnectorCare in public.

The Health Connector's goal was to keep premiums from going up for these low-income people. Using dedicated funding in the state budget, and competitive rates negotiated with insurance carriers, the Health Connector was able to do just that.  Base enrollee premiums in ConnectorCare will mirror base enrollee premiums in today’s Commonwealth Care program.  And, the Health Connector was able to use funds to narrow the spread between the lowest and highest cost plans for premium payers.

Chart showing premiums for ConnectorCare in 2014We're particularly pleased that ConnectorCare enrollees at or below the poverty level will not pay a premium, no matter which plan they choose, just as they do today.  The Health Connector had previously considered charging this population small premiums.  Massachusetts Law Reform Institute and Health Care For All weighed in with why this would be a bad idea (see our fact sheet, pdf).

Today's premium affordability decision is a major victory for lower income Health Connector enrollees.  Thanks to all those involved who made sure coverage remains affordable for this population.
-Suzanne Curry