As an example, the Connector requires each participating carrier to offer plans at all four metal levels; the ACA only requires exchange carriers to offer at least one gold plan and one silver plan in many areas of the country, there are no longer any platinum plan for sale; in Massachusetts, there are platinum plans for sale from each of the insurers.
The exchange utilized its active purchaser role for to limit the number of available plans. For , there were plans are available, and the Connector said that would decrease to 81 or fewer for The exchange felt the previously-available plethora of plan options—often with only minor differences from one plan to another—made the selection process too confusing for enrollees.
By , there were only 52 individual market plans for sale via MA Health Connector, although that increased to 57 for The move to simplify plan offerings starting in was met with mixed opinions from board members and stakeholders. But there have been some changes in insurer participation over the years:. Dental carriers Guardian and MetLife exited the exchange at the end of , but they only offered group dental coverage, rather than individual market coverage. In August , however, it became apparent that Minuteman would not be able to reopen as a for-profit insurer in , because they had not raised enough capital by the August 16 deadline to get licensed as a new insurer.
As a result, Minuteman Health enrollees in Massachusetts and New Hampshire had to switch to new plans for , and did not have an opportunity to buy a for-profit version of Minuteman coverage. A July Health Connector memo indicated that CeltiCare Ambetter would not participate in the individual market in Massachusetts in So their departure did not have a significant impact.
For , UnitedHealthcare returned to the exchange, although not of their own volition. This was well under the 12 to 13 percent nationwide average for the nationwide average applies to the individual market along; Massachusetts and Vermont are the only two states where the individual and small group risk pools have been merged.
DC also has a modified merged risk pool. That assumed, however, that people kept their existing plans in In reality, there was a much higher rate of plan switching during the open enrollment period: 65, Massachusetts Health Connector enrollees picked new plans for , which was roughly four times the percentage of plan changes that the exchange had seen in prior years. But ConnectorCare subsidies were also smaller in , and people who are enrolled in the highest-cost plans were no longer receiving the level of ConnectorCare subsidies they received in the past.
The result of all this was that the additional subsidies for ConnectorCare plans was concentrated on lower-cost plans for As of October 12, Massachusetts Health Connector intended to implement premiums for that were based on the assumption that cost-sharing reduction CSR funding would continue in The average rate increase at that point was just 8.
But it was later that same day that the Trump Administration announced that CSR funding would end immediately. In nearly every state, the eventual result was that the cost of CSR got added to premiums typically just to silver plan premiums, as CSR benefits only apply to silver plans.
The result was that silver plan premiums increased by an average of 26 percent in Massachusetts, instead of the Overall, the average rate increase across all plans was 18 percent, driven in large part by the spike in silver plan rates.
Average premiums for Massachusetts Health Connector plans are 4. The average increase by insurer ranged from a 1. As of , UnitedHealthcare had more than 5, enrollees in small group plans in Massachusetts, so they had to file plans to offer on-exchange coverage in both the individual and small group markets for but only in the Boston metro area.
UnitedHealthcare previously participated in the Massachusetts exchange, but exited at the end of The weighted average rate increase for was about 5.
There are also small group dental plans available from Altus Dental and Delta Dental. Massachusetts is keeping their small group definition at 50 or fewer employees, and the day after HR was enacted, the state rescinded their guidance that allowed mid-size groups to early renew. In March , Massachusetts Health Connector began a partnership with the New England Business Association, to make health coverage more accessible to small businesses.
Massachusetts enacted comprehensive health reform in that created the Massachusetts Health Connector. While the ACA health insurance marketplaces were modeled on the Massachusetts exchange, the technical upgrades that were needed to make Health Connector ACA-compliant were not implemented smoothly or on time. MITRE determined that CGI—the lead IT vendor—lacked the necessary expertise, managed the project poorly, lost data, and failed to adequately test the revamped website prior to its launch.
Despite the issues with CGI, state officials deemed it too disruptive to cut ties with the vendor during the open enrollment. In January , Massachusetts brought on Optum, a subsidiary of United HealthGroup, to work through some of the immediate problems with the Health Connector. One track evaluated replacing existing Health Connector software with hCentive, an off-the-shelf software solution that was successfully used by the Colorado, Kentucky, and New York exchanges.
The second track considered was transitioning to the federal exchange, HealthCare. After additional testing in August, Massachusetts and CMS determined that continuing as a state-run exchange using the hCentive platform was the right approach for the state.
The hCentive system was customized for the Massachusetts insurance marketplace. Health Connector performance was greatly improved in However, officials acknowledged many additional fixes were still needed, and consumers continued to struggle with the online payment system and long waits for customer assistance.
Charlie Baker was sworn into office in January , and he moved quickly to bring changes to the Health Connector leadership ranks. That law became the model for the ACA, which when passed, allowed Massachusetts to further expand its healthcare coverage. Today, only 3. Massachusetts has been a clear leader when it comes to health care coverage, and as a result, outpaces other states in health care outcomes.
But it has taken a village of health care policymakers, economists, practitioners, community leaders, and legislators to create an insurance coverage system that not only works, but that also rises above partisan acrimony. How did the state manage to be almost radically bipartisan when it comes to health care, or at least sensibly pragmatic? Another ingredient in the successful overhaul, according to John E. McDonough, professor of public health practice at the Harvard T.
What does the evidence tell us? About 22 percent of adults in Massachusetts have trouble paying medical bills, according to a new report by Washington-based consultancy Altarum, with many complaining that high-deductible health plans come with steep out-of-pocket costs. Additional Information 3. Member Selection 4. Your Health Care Needs 5. Shop Plans 6. Medical Assistance and MinnesotaCare When you apply for financial help through MNsure, you will find out if you qualify for low-cost or no-cost health insurance either through Medical Assistance or MinnesotaCare.
Get details about these programs at the following links: Medical Assistance MA is Minnesota's Medicaid program for people with low income. MA does not require you to pay a monthly premium. MinnesotaCare is a program for Minnesotans with low incomes who do not have access to affordable health care coverage.
MinnesotaCare may require you to pay a monthly premium, and it is based on your household size and income. MinnesotaCare members may have small co-pays.
See If You Qualify You can get an idea of whether you qualify for Medical Assistance or MinnesotaCare based on your household size and income by using MNsure's plan comparison tool or the income guidelines. You are age 65 or older.
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