MORE ABOUT THE HEALTH REFORM LAW
In addition to establishing the new Commonwealth Care insurance plan to replace Free Care, Chapter 58 of the Acts of 2006: An Act Providing Access To Affordable, Quality, Accountable Health Care has some other important provisions.
The Health Reform law expands MassHealth coverage for children up to 300% of poverty ($60,000/family of 4, until 4/1/07).
It also establishes an authority called the “ Commonwealth Health Insurance Connector”.
The Connector
In addition to administering Commonwealth Care, The Connector:
- Offers plans to small businesses (50 or fewer employees) and individuals.
- Sets subsidy levels for the Commonwealth Care program, sets the affordability standards for the individual mandate, and decides what insurance plans can be offered through the Connector.
- Allows multiple employers to contribute to an employee’s premium.
Insurance Market Reforms:
Under the new law:
- Eligible workers and their families can buy coverage with pre-tax dollars.
- Insurers are encouraged to create plans with lower premiums that still provide comprehensive benefits. Current mandated health benefits, including mental health care, are protected.
- Non-group (individual) health insurance market merges into the small group market, which could cut individual premiums by around 25%.
- New, lower-premium products will be created for 19 to 26 year olds.
- Requires health plans to offer family coverage to young adults for two years after they lose their dependent status or up to age 25, which ever comes first.
Free Care Pool:
- Uncompensated Care Pool continues with no changes in funding or regulations until October 1, 2007.
- On October 1, 2007, the Uncompensated Care Pool becomes Health Safety Net Trust Fund administered by Office of Medicaid.
Other Components:
- Establishes Disparities Council and Quality and Cost Council.
- Restores $20 million for public health prevention programs.
- Allocates $3 million in outreach grants to community groups.
- Convenes an Advisory Council to study Community Health Worker Outreach to reduce barriers to health care, particularly in ethnic and racial minority communities.
-Adapted fromwww.hcfama.org/_uploads/documents/live/Final%20Regs.pdf
9/06