A few weeks ago, officials from EOHHS, MassHealth, and the Connector publicly announced their recommendation to implement a Basic Health Plan (BHP) in Massachusetts, to be administered by MassHealth, beginning in January 2014 (see this state powerpoint for analysis and details). Health Care For All and the Affordable Care Today!! coalition strongly support this decision.
In order to begin planning ACA implementation, the administration needs legislative authorization in a number of areas. HCFA urges the Legislature to quickly enact the needed provisions.
The Affordable Care Act (ACA) gives States the option to administer a Basic Health Plan for individuals just above Medicaid-eligible income levels, that is, between 134-200% of the federal poverty level (fpl) – about $14,900-$22,300/year for individuals – and legal immigrants 0-200% fpl.
The State will receive 95% of the premium and cost-sharing subsidies that would have been allotted if these individuals had purchased coverage through the Exchange. From their analysis, EOHHS and the Connector concluded that the Massachusetts BHP could be financed with just federal dollars. This will save the state hundreds of millions of dollars, as coverage for many of these people is currently only paid for 50% by the federal government. Others will move from full state expense to being fully federal. Under the BHP, the State will offer choices of coverage plans to enrollees, similar to MassHealth managed care and Commonwealth Care.
We strongly agree with the analysis of the benefits of implementing a BHP, as laid out by MassHealth:
- Provide better benefits at a lower cost than if purchased individually through the Exchange
- Improve continuity of coverage and care by reducing churn
- Enhance member protections by aligning MassHealth appeals, fair hearing rules and processes
In addition, the BHP protects consumers from having to pay back subsidies to the federal government if their income goes up during the year.
The Administration also plans to seek authority from the Legislature to maintain existing subsidy levels for residents between 200-300% fpl, who in 2014 will buy commercial insurance through the Connector, with partial federal tax credits.
We at Health Care For All and the ACT!! Coalition appreciate the Administration’s efforts to build upon the gains of providing affordable health coverage to low-income residents through implementation of the ACA.