Latest news with #HealthConnector
Yahoo
01-06-2025
- Business
- Yahoo
Health coverage losses in Mass. may be even steeper
BOSTON (SHNS) – Tens of thousands of Bay Staters could lose subsidized health insurance through the Massachusetts Health Connector and premiums could rise for most other members under a suite of reforms in the U.S. House-approved reconciliation bill that Gov. Maura Healey dubbed 'devastating.' For months, officials and health care activists have been warning about major impacts to MassHealth from the Medicaid changes sought by Republicans in Congress, who want to fund tax cuts and rein in what they describe as wasteful spending. But the sweeping package that cleared the U.S. House last week features many other provisions that could also impact state-run health insurance marketplaces, including limitations on tax credit eligibility for some immigrants and a shorter open enrollment period. Massachusetts Health Connector Executive Director Audrey Morse Gasteier said as many as 100,000 people — roughly a quarter of all who get their health insurance through the marketplace — could lose their coverage. Taken alongside the roughly 150,000 other people who would lose MassHealth eligibility, Morse Gasteier said the House-approved bill would effectively double the number of Bay Staters without health insurance. '[That] is just such a heartbreaking and catastrophic future to contemplate after Massachusetts, for nearly 20 years, has been at the forefront and really all in on making sure everybody in Massachusetts has health coverage,' Morse Gasteier told the News Service. A Connector spokesperson said the most recent U.S. Census data estimates about 2.6% of Massachusetts residents are uninsured. State law requires Massachusetts residents to be insured, or pay a tax penalty. A June 2024 Center for Health Information and Analysis report estimated 1.7% of Massachusetts residents reported being uninsured in 2023, which translates into about 116,594 residents. Nearly 90% of the uninsured were adults aged 19 to 64, four-fifths were male, and two-thirds of the uninsured had a family income below 300% of the federal poverty level. Under the House bill, premiums are also likely to rise for those who remain insured through Connector plans, Morse Gasteier said. She also forecast a major financial impact, saying the policy changes in the bill and the expected end-of-year expiration of tax credits to help reduce premiums would cost residents and the state a combined $750 million per year. The sweeping federal legislation, which also touches on immigration, artificial intelligence and food aid, features numerous eligibility and spending reforms affecting Medicaid programs and health care marketplaces under the Affordable Care Act. Hannah Frigand, senior director of HelpLine and public policies at Health Care for All, described the package as a 'backdoor repeal of ACA marketplace coverage.' 'It seems like almost the intent of some of these decisions in here is to make it more difficult for the state to provide meaningful access to affordable coverage to individuals,' she said. 'It's so directly attacking [ACA marketplace coverage] in multiple ways to make it less affordable and less accessible.' Kaitlyn Kenney Walsh, vice president of policy and research at the Blue Cross Blue Shield of Massachusetts Foundation, said the policies 'will have significant deleterious impact on people getting health insurance coverage through the Health Connector who have come to rely on that coverage.' U.S. House Speaker Mike Johnson has targeted July 4 as the deadline to get a final bill to President Donald Trump's desk in order to provide tax relief 'as soon as possible.' 'We have a very delicate equilibrium that we reached on here,' Johnson said last week. 'A lot of work went into this to find exactly the right balance.' It's not clear how the U.S. Senate will respond to the proposal, and a handful of Republicans have voiced concerns that the measure either does not do enough to reduce the national deficit or would harm Medicaid recipients. One of the most significant changes in the bill limits the eligibility of many immigrants for tax credits to help reduce the cost of health insurance plans through state-run marketplaces like the Connector. Under the bill, only lawful permanent residents, Compact of Free Association (COFA) migrants or certain immigrants from Cuba would qualify for subsidized marketplace coverage. Morse Gasteier said that change would cut 55,000 to 60,000 other legally present immigrants in Massachusetts, like those seeking asylum, refugees and those waiting for Medicaid eligibility to begin, from the Health Connector's ranks. The federal bill would create new verification requirements for marketplaces, preventing enrollees from receiving tax credits toward premiums or cost-sharing reductions until their eligibility is confirmed, according to a detailed analysis by health policy nonprofit KFF. It would also largely limit auto-renewals and mandate marketplaces hold annual open enrollment periods from Nov. 1 to Dec. 15, about five weeks shorter than the Health Connector has offered for more than a decade. 'The bill would make it so that people need to verify information before they even see that they qualified for a lower-cost option, which will effectively mean that many people will just think they don't qualify and will not even try to submit documents because they think, 'I'm not eligible for subsidized coverage,' which will prevent many people from actually enrolling into insurance,' Frigand said. Morse Gasteier said the additional hurdles will 'make the process of obtaining and keeping coverage harder for everybody.' If fewer people are covered, she said, the remaining insured population will become higher-risk and higher-cost as a result. 'With respect to the administrative burdens and the red tape and the needless kind of sludge that this bill would erect for people that are trying to get and keep coverage, we would expect — just based on the way health insurance works and the way human behavior operates — younger and healthier people will probably not go through the trouble of making their way through all of these hoops,' she said. And when Bay Staters get ill or injured while not carrying insurance, the eventual health care costs will be 'borne by our entire health care system and passed on to premium payers through hospital debt that needs to be spread across the rest of the population,' Morse Gasteier said. Some of the impact could come not from the reconciliation package itself, but from congressional inaction. The pandemic-era American Rescue Plan Act and Inflation Reduction Act expanded ACA tax credits that help subsidize premium costs, and those credits are set to expire at the end of the year. The federal bill on the move does not extend those credits. 'It's been a really significant help to the state, to the ConnectorCare program and to individuals who are just over that cliff for eligibility for those premium subsidies under the Affordable Care Act baseline,' Morse Gasteier said. State law requires most adults who can afford it to have health insurance coverage for the entire year or pay a tax penalty. Many Bay Staters get health insurance through their employers, and MassHealth provides coverage to those with low incomes or disabilities. The Connector offers plans for individuals who do not qualify for MassHealth and also cannot get covered through their employers, such as people working multiple part-time jobs or gig workers, as well as a subsidized ConnectorCare Program. Healey described the Connector's membership as 'people who make just a little bit too much to qualify for MassHealth but are still just getting by.' 'Who are these people? There are a lot of people running small businesses. They're people who are self-employed,' Healey said at a Tuesday event where she warned about major health care impacts from the reconciliation bill. 'The Republicans and Donald Trump want to slash funding for the Health Connector as well, and this is going to drive up premiums, force 100,000 families to go without coverage. So you can see, the proposed cuts, if they go through, they're devastating for Massachusetts residents, for families, for employers, for our economy, for people across the state.' Lawmakers and Healey agreed on a pilot expanding income eligibility for the ConnectorCare program from 300% of the federal poverty level to 500%. Both Healey and the House in their fiscal 2026 budget bills proposed extending the pilot another year, but the Senate did not include the extension in its redraft. Sen. Cindy Friedman, co-chair of Senate Committee on Steering and Policy, noted Wednesday that the pilot is available, albeit temporarily. 'I would like you to tell your patients that, while it lasts, the Connector in Massachusetts has raised their subsidies to 500% of the poverty level,' Friedman told the CEO of an organization that operates sexual and reproductive health clinics. 'And that has made a real profound difference in people getting into health care.' WWLP-22News, an NBC affiliate, began broadcasting in March 1953 to provide local news, network, syndicated, and local programming to western Massachusetts. Watch the 22News Digital Edition weekdays at 4 p.m. on Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Business Journals
05-05-2025
- Business
- Business Journals
Massachusetts Health Connector for Business is a smart place to find high-value health coverage for your employees
In today's competitive labor market, offering quality health insurance isn't just a perk — it's a powerful tool for attracting and retaining employees. But for many small to midsize businesses, navigating the world of health benefits can be overwhelming, especially when cost is a critical concern. Here in Massachusetts, one powerful solution is Health Connector for Business — the Commonwealth's official health insurance marketplace for businesses with 50 employees or less. Backed by a long-standing commitment to health care access and innovation, Health Connector for Business offers cost-effective, flexible health and dental insurance coverage. Through the Health Connector, employers can access competitive plans from top insurers at rates potentially lower than those in the open market. And now, with the new Premium Value Plan label, it's even easier to find an affordable, high-quality employee health plan at The Premium Value Plan label helps small businesses quickly identify options with lower premium costs that deliver the same benefits and access to services as higher-cost plans. 'I'm super happy with Health Connector for Business,' said Mario Campos, owner of two Stanley Steemer locations in Massachusetts. 'I have great options for employees and would recommend the Premium Value Plan to other businesses. The new label helps a lot because it's right there. It's easy to find. Great value, right on the website.' expand And there are plenty of other benefits to using Health Connector for Business, especially for small business owners with a lot on their plates. Quality, affordable coverage for businesses and employees Health Connector for Business makes it easier for companies to offer affordable health coverage to their employees. The Premium Value Plan makes it easy to find plans that deliver the same benefits and coverage as similar plans, but with premiums that can be as much as 20% less. The ConnectWell wellness program delivers 15% premium rebates – on average nearly $5,000 a year – and $100 gift cards to participating employees. And federal tax credits are available to some companies with fewer than 25 employees, reducing premiums by up to half. Simple, flexible health care for your business The Health Connector for Business website is easy to use, with clear, side-by-side comparisons of premiums, deductibles and networks. The platform is designed with small businesses in mind, making it easy to set up, manage and renew coverage each year. Plus, employers can choose to offer one plan to all employees or allow employees to pick from a menu of plans from a single carrier. This kind of flexibility is rare in traditional group insurance and allows each of your employees to choose a plan that works for them. The same high-quality health insurers as the open market You'll find competitive plans from top insurers on Health Connector for Business. This means employers can offer their teams coverage from carriers they know and trust, while benefiting from the Health Connector marketplace pricing and structure. An essential benefit for your employees The greater Boston area has one of the most competitive labor markets in the country. For startups, family-owned businesses and growing companies in the region, offering quality health benefits is essential to attracting — and keeping — talent. And business owners agree on the importance of employee health care options. 'The biggest benefit for us has been retaining quality employees, which ends up saving us a lot of money in the long run,' said Steve Sanderson, owner of Riverwalk Brewing and a Health Connector for Business customer. Simple to use with dedicated support As a business owner, you wear a lot of hats. It's important to have the right tools and support at your fingertips. The Health Connector's online tools make it easy to enroll in and maintain your health plans. Business owners can also access free assistance through certified brokers listed on the website, so support is just a click away. And for businesses that have been managing benefits manually or juggling complex broker relationships, this simplicity is a welcome shift. The bottom line for small business owners Health Connector for Business offers Massachusetts employers a rare combination: high-quality coverage from top insurers, affordable prices and flexible plan designs — all within a platform built for the state's small business community. Using Health Connector for Business is more than a practical decision — it's a strategic one. With Premium Value Plans, wellness rebates for employers and employees, and access to free, experienced certified brokers, Health Connector for Business is the best way to find affordable, high-quality coverage for small businesses.
Yahoo
14-02-2025
- Business
- Yahoo
Massachusetts agrees to higher insurance plan deductibles
BOSTON (SHNS) – Regulators approved higher deductible limits for health plans in 2026, but stressed reforms are needed to tackle affordability concerns and ensure Bay Staters don't end up 'self-rationing' care. Most residents ages 18+ are required to have health insurance under state law, and regulators set deductible limits each year that help specify what type of plan coverage is sufficient. People face tax penalties if they do not enroll in affordable coverage or their plan falls short of certain standards. The Massachusetts Health Connector Board voted to raise the minimum creditable coverage (MCC) deductible limit for individuals to $3,200 in 2026, up from $2,950. The new limit for families would be $6,400 in 2026, compared to the current $5,900. Regulators last year did not raise limits and maintained the same threshold from 2024 due to high inflation. The higher deductible limits mean policyholders might need to pay more out of pocket, but also create more flexibility for insurers and employers as they design plans and keep up with rising care costs and inflation. 'Each year, we aim to balance our responsibility to set a common standard or floor, while also ensuring that people with generally robust or market-standard coverage are not penalized,' Kayla Scire, associate director of policy at the Health Connector, said during a meeting. The tax penalty could cost people between $300 and $2,200, the Department of Revenue said this month. Board member Erik Gulko, president of Innovo Benefits Group, was 'very happy' about the higher limits. 'I look at it this way: There are a lot of taxpayers that have plans that are $3,000-deductible,' Gulko said. 'And over the last year, when we had it at $2,950, because of a $50 difference, they have been unexpectedly and inadvertently subject to a tax. So I'm happy that all those that have that $3,000 deductible, they don't have to pay a tax now. It's a great change.' Board member Michael Chernew said he supported the staff's recommendation to adjust the deductible limit, but more broadly criticized the use of deductibles and their impact on cost-sharing. Chernew, a health care policy professor at Harvard Medical School, said deductibles can discourage people from seeking care. 'I'm not a fan of deductibles because of a bunch of other distortionary things that deductibles use,' he said. 'I think what we're voting for is some level of flexibility to allow plans to battle how they use deductible and cost-sharing things, and they will do what they will do. But I am not a fan.' As deductibles rise, more people forgo care, warned state Insurance Commissioner Michael Caljouw. 'You wonder if there's a somewhat illusory insurance target that isn't really as highly insured a number because of the prevalence of deductibles,' Caljouw said. 'At the same time, there's a connection between the level of the deductible and the overall premium amount. It's sort of a regrettable artifact of plan design.' Caljouw encouraged regulators to explore additional tools to adjust deductible amounts and ensure 'members aren't the ones that are bearing the costs directly.' Massachusetts is at an 'affordability crossroad,' he said. 'As we grapple with those issues, consumer cost share at large has to be one of the priorities for us,' Caljouw said. 'Because if it remains largely unaddressed over time, through that policy lever conversation, I fear that we will begin to see rationing, self-rationing of care, increase even further than we have now, particularly with a disproportionate impact on low-income communities.' Nancy Turnbull, who was elected Thursday to serve as the board's vice chair, noted escalating tension between the state's individual health insurance mandate and how regulators set creditable coverage standards. 'If deductibles keep going up, and up, and up, and we can't control premiums, I think one of the tensions — in addition to all of the others and choices that other members of the board have made — is whether we will continue to feel comfortable obligating our fellow residents of the state to buy coverage that has higher, and higher, and higher deductibles,' Turnbull said. 'And if we don't, and some of us might not, that will erode the mandate and that will erode some of the progress that we've made.' The Group Insurance Commission, which provides coverage for state employees, has kept deductibles, copays and out-of-pocket limits stable for eight years, said Executive Director Matthew Veno. That's translated into lower consumer costs compared to plans available through the Health Connector, he said. 'But that comes at a tremendous cost, right? And it's a cost to the plan sponsor, and in my case, it's a cost to the state budget,' Veno said. 'And it's not insubstantial.' Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
