maintaining affordable health coverage in massachusetts suzanne curry health care for all...
TRANSCRIPT
![Page 1: Maintaining Affordable Health Coverage in Massachusetts Suzanne Curry Health Care For All scurry@hcfama.org Families USA Health Action 2015 January 23,](https://reader036.vdocument.in/reader036/viewer/2022062322/56649cb55503460f94978e32/html5/thumbnails/1.jpg)
Maintaining Affordable Health Coverage in Massachusetts
Suzanne CurryHealth Care For [email protected]
Families USA Health Action 2015January 23, 2015
![Page 2: Maintaining Affordable Health Coverage in Massachusetts Suzanne Curry Health Care For All scurry@hcfama.org Families USA Health Action 2015 January 23,](https://reader036.vdocument.in/reader036/viewer/2022062322/56649cb55503460f94978e32/html5/thumbnails/2.jpg)
Massachusetts Health Reform 2006
2
![Page 3: Maintaining Affordable Health Coverage in Massachusetts Suzanne Curry Health Care For All scurry@hcfama.org Families USA Health Action 2015 January 23,](https://reader036.vdocument.in/reader036/viewer/2022062322/56649cb55503460f94978e32/html5/thumbnails/3.jpg)
Determining Affordabilityo Community Catalyst study looked at:
Greater Boston Interfaith Organization Study MassFESS (Family Economic Self-Sufficiency
Standard)Economic Policy Institute Basic Family Budget
o Showed people <300% FPL barely have enough income to cover basic needs (before health care costs)
![Page 4: Maintaining Affordable Health Coverage in Massachusetts Suzanne Curry Health Care For All scurry@hcfama.org Families USA Health Action 2015 January 23,](https://reader036.vdocument.in/reader036/viewer/2022062322/56649cb55503460f94978e32/html5/thumbnails/4.jpg)
Commonwealth Care
o Comprehensive health coverage for adults at or below 300% FPL not eligible for MassHealth (Medicaid)
o Run by the Health Connector (MA marketplace)
o Sliding scale premiums based on income, copays also based on income: Plan Types 1, 2, 3
o Cannot be offered health insurance from job
o As of December 31, 2013, about 220,000 enrollees
![Page 5: Maintaining Affordable Health Coverage in Massachusetts Suzanne Curry Health Care For All scurry@hcfama.org Families USA Health Action 2015 January 23,](https://reader036.vdocument.in/reader036/viewer/2022062322/56649cb55503460f94978e32/html5/thumbnails/5.jpg)
![Page 6: Maintaining Affordable Health Coverage in Massachusetts Suzanne Curry Health Care For All scurry@hcfama.org Families USA Health Action 2015 January 23,](https://reader036.vdocument.in/reader036/viewer/2022062322/56649cb55503460f94978e32/html5/thumbnails/6.jpg)
Why State “Wrap”* Needed
Income $11,916 $23,900 $35,500
ConnectorCare Premiums
ACA Premiums
* “ConnectorCare”
![Page 7: Maintaining Affordable Health Coverage in Massachusetts Suzanne Curry Health Care For All scurry@hcfama.org Families USA Health Action 2015 January 23,](https://reader036.vdocument.in/reader036/viewer/2022062322/56649cb55503460f94978e32/html5/thumbnails/7.jpg)
ACA vs. MA Premiums & Cost Sharing
![Page 8: Maintaining Affordable Health Coverage in Massachusetts Suzanne Curry Health Care For All scurry@hcfama.org Families USA Health Action 2015 January 23,](https://reader036.vdocument.in/reader036/viewer/2022062322/56649cb55503460f94978e32/html5/thumbnails/8.jpg)
ConnectorCareo Coverage designed to look like Commonwealth
Careo Eligibility
o Meet eligibility standards for federal APTCso Income at or below 300% FPLo Must choose from subset of plans offered
through the Health Connector (mostly Medicaid MMCOs)
![Page 9: Maintaining Affordable Health Coverage in Massachusetts Suzanne Curry Health Care For All scurry@hcfama.org Families USA Health Action 2015 January 23,](https://reader036.vdocument.in/reader036/viewer/2022062322/56649cb55503460f94978e32/html5/thumbnails/9.jpg)
ConnectorCare Premiums
![Page 10: Maintaining Affordable Health Coverage in Massachusetts Suzanne Curry Health Care For All scurry@hcfama.org Families USA Health Action 2015 January 23,](https://reader036.vdocument.in/reader036/viewer/2022062322/56649cb55503460f94978e32/html5/thumbnails/10.jpg)
ConnectorCare Cost-Sharingo Co-pays only; no deductibles or co-insuranceo Mirrors actuarial value of Commonwealth Care
o Plan Type 1 (at or below 100% FPL): Medicaid-level co-pays (for prescription drugs only) (~99% AV)
o Plan Type 2 (100-200% FPL): Low to moderate co-pays (~97% AV)
o Plan Type 3 (200-300% FPL): Moderate co-pays (~95% AV)
![Page 11: Maintaining Affordable Health Coverage in Massachusetts Suzanne Curry Health Care For All scurry@hcfama.org Families USA Health Action 2015 January 23,](https://reader036.vdocument.in/reader036/viewer/2022062322/56649cb55503460f94978e32/html5/thumbnails/11.jpg)
ConnectorCare Fundingo Federal APTCs + Federal Cost-Sharing Reductions +
State Funds = ConnectorCare Subsidieso FY2015 Budget estimated cost at $235 milliono State funding sources include a portion of the
cigarette tax, individual mandate penalties, employer assessment
o 50% federal reimbursement for premium wrap portion only (for citizens and qualified immigrants) through 1115 Medicaid Demonstration waiver
![Page 12: Maintaining Affordable Health Coverage in Massachusetts Suzanne Curry Health Care For All scurry@hcfama.org Families USA Health Action 2015 January 23,](https://reader036.vdocument.in/reader036/viewer/2022062322/56649cb55503460f94978e32/html5/thumbnails/12.jpg)
Thank you!
Questions?