Yesterday, the State House of Representatives released their annual budget proposal for Fiscal Year 2024, which included a pilot program to expand eligibility for Massachusetts’ subsidized health insurance program, ConnectorCare. The pilot will provide direct relief and enable tens of thousands of residents who currently don’t qualify to get access to affordable coverage and the care they need.
The two-year pilot program will expand eligibility for the state’s ConnectorCare program from 300% of the federal poverty level (FPL) which is about $43,000 a year for an individual to 500% FPL which is about $73,000 a year. For those newly eligible, it will lower co-pays, deductibles, and premiums that have continued to squeeze families and put care out of reach. The pilot is also able to be fully paid for by leveraging the savings from enhanced federal subsidies passed by Congress that are accruing to the state’s Commonwealth Care Trust Fund which was explicitly created to support affordable care. The pilot reflects legislation introduced by Representatives Driscoll and Barber and Senator Cronin.
The timing could not be more critical for this pilot. On April 1st the federal Medicaid protections ended, and now millions of Massachusetts residents will need to go through a “redetermination” process to see if they are still eligible for MassHealth. Many individuals will continue on MassHealth, but others will find they are no longer eligible and will need to transition to a more expensive insurance option. The ConnectorCare expansion will help ease the transition off of MassHealth by providing more affordable options for people who would otherwise not be eligible for subsidized coverage.
The pilot will also tackle broader health care access and equity challenges and help to avoid the “cliff” that many working people experience when their income rises just over the current eligibility limit for ConnectorCare. Often, they quickly find themselves facing insurance options that have expensive premiums and deductibles that can be thousands of dollars a year. Despite high levels of health insurance coverage in Massachusetts, more than 40% of residents report challenges affording care with Black and Hispanic/Latinx residents even more likely to report challenges accessing care due to cost. The disparities are actually most stark for those above the ConnectorCare eligibility level because of the lack of affordable coverage options.
At a time of rising costs across the board, out-of-pocket health care costs force too many people to avoid needed care and treatment. Health Care For All hears from people who struggle with the high cost of health care every day on our HelpLine, including those who often delay doctors’ visits or skip taking medications because they can’t afford them. The ConnectorCare expansion pilot will be life changing for these individuals and the many Massachusetts residents who do not have affordable employer insurance and must purchase costly plans on their own.
The Massachusetts House has shown tremendous leadership in including this proposal in the FY24 budget. With the rising cost of living in the state and the current MassHealth redetermination campaign underway, access to affordable health coverage is more pressing than ever. We urge legislators to continue to champion the proposal and pass this historic health care expansion so Massachusetts residents can get the care they need.
Grace Jurkovich is a Policy & Project Coordinator at Health Care For All