Massachusetts Health Insurance Exchange Guide
Health Exchange • April 2, 2013 at 3:35 PM • Written by: PeopleKeep Team
Starting in 2014, as part of the Affordable Care Act (ACA), health insurance coverage for individuals and small businesses will become available through new state health insurance marketplaces.
Massachusetts is no stranger to healthcare reform, or to offering a state health insurance exchange. In 2006, comprehensive state health reform legislation was signed into law to provide near-universal health coverage for Massachusetts residents.
As part of their state health care reform in 2006, they opened a state health insurance exchange, MA Health Connector (www.mahealthconnector.org). They will continue to offer MA Health Connector to satisfy ACA insurance exchange requirements.
What is the Massachusetts Health Insurance Exchange?
MA Health Connection, Massachusetts's state-based health insurance exchange, offers the following programs:
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Commonwealth Care provides subsidized coverage for individuals with incomes below 300% of the federal poverty level ($33,510 for an individual and $69,150 for a family of four in 2012).
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Commonwealth Choice enables those who are not eligible for Commonwealth Care to shop for and purchase insurance offered by private health plans. This will become the state-based individual health insurance exchange, as required under federal ACA law.
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In 2010, the MA Health Connector launched the Business Express program for businesses with 50 or fewer employees. This will become the Small Business "SHOP" exchange, required under federal ACA law.
In 2012, 98.1% of all Massachusetts residents were insured, including 99.8% percent of children and 99.6% percent of seniors.
How was the MA Health Insurance Exchange Formed?
On April 12, 2006, former Governor Mitt Romney signed into law comprehensive health reform legislation designed to provide near-universal health coverage for state residents. The Massachusetts health reform law became the model for national health reform.
In 2012, Governor Deval Patrick enacted two laws affecting the Health Connector. First, the law authorized the Health Connector to be certified as a state-based exchange as defined in the Affordable Care Act (ACA) and gave the Connector authority to perform key tasks, such as establishing a Navigator program and administering appeals related to the federal exchange. The second law included a number of provisions related to the ACA, including: designating the Health Connector as the entity to conduct risk adjustment; authorizing the Health Connector to sell stand-alone dental, vision, catastrophic, and child-only plans; and designating the Health and Human Services Department (known as MassHealth) to administer the Basic Health Plan option.
On December 7, 2012 Massachusetts received conditional approval from the U.S. Department of Health and Human Services (HHS) to establish a state-based exchange.
