How the Affordable Care Act Could Affect MA Residents

Thursday, October 03, 2013

Paige Pihl Buckley, GoLocalWorcester Contributor

The Affordable Care Act officially took effect on Tuesday.

With its marketplace officially opening on Tuesday, the Affordable Care Act has finally transformed from a political bargaining chip to a reality for many Bay State residents. Although the universal healthcare system already in place in Massachusetts was considered a model for the national program, the ACA’s implementation has brought some significant changes to the state.

“For people who get their insurance through their work, they’re not really going to see much of a change,” said Jason Lefferts, spokesman for the Massachusetts Health Connector, “but then there’s everybody else. The Affordable Care Act creates expanded choice and subsidies.”

The Massachusetts Health Connector is the Bay State’s health care insurance exchange. Changes will be most significant for those already using the Mass. Health Connector, but qualifications for subsidies have been expanded so enrollment will be open to individuals and families who previously did not qualify.

Medicaid Rolls to Expand

Under the Affordable Care Act residents with an income of 133% of the federal poverty level or lower will now qualify for Medicaid. Those between 133% and 400% of the federal poverty level will qualify for insurance subsidies, to be paid in the form of lower premiums or a federal income tax refund.

Before the ACA’s implementation, qualification for Medicaid required an income of 100% of the federal poverty level or lower, and subsidies required an income of 100% to 400% of the federal poverty level. An individual living at 400% of the federal poverty level would make $45,000 annually, and a family of would make $94,000.

New federal subsidies are lower than the previous subsidies, but those who received subsidized healthcare before the ACA’s implementation will receive an additional subsidy from the state.

“The people who remain on the high side of the spectrum are now going to be receiving these subsidies with the state supplement,” said Robert Seifert of UMass Medical School’s Center for Health Law and Economics. “The supplement will be ongoing. The state is able to do this because a lot of the money that was being spent on Commonwealth Care subsidies is now being replaced by federal money coming in.”

Commonwealth care is the title of the subsidized insurance plans previously available under Massachusetts’ Mass. Health Connector. Those who newly qualify for subsidies - anyone between 300% and 400% of the federal poverty level – will not receive a state supplement.

“The Affordable Care Act is going to take it a little bit further and enable Massachusetts to cover even more people than were able to get coverage before,” said Seifert.

Residents who qualify for Medicaid under the new law will be automatically enrolled and notified via snail mail. Those who formerly qualified for subsidies and those who newly qualify will have to proactively reenroll or enroll. Former Commonwealth Care users will be notified by phone and snail of their need to reenroll before the New Year.

New enrollees will be met with increased options. The number of insurance carriers offered in the Bay State has risen from nine to ten, and the number of plans has risen from 99 to 114, Lefferts said.

Changes for Employers

Another key change will be for those unable to afford their employers’ insurance offerings. Previously, those who opted not to partake in employer provided insurance were automatically disqualified from Medicaid and other subsidized healthcare. Under the Affordable Care Act, employees who refuse an employer’s insurance offering still qualify for Medicaid and subsidies if the plan offered cost more than 8% of their salary, explained Seifert.

Other key changes include the ability of young people to remain on their parents’ insurance plans until the age of 26, no strings attached. That piece was implemented last year and was widely supported.

Preventive health service, like cancer screening and vaccines, will now be provided free of charge under most insurance plans. Other perks include more federal money to subsidize the prescriptions of seniors and to fund community health centers.

There is no doubt that the Affordable Care Act remains controversial, but the number of people enrolling in the newly opened marketplace indicates a clear demand as well.

Those currently covered under Commonwealth Healthcare will be covered through the end of the year when plans purchased through the new marketplace will take effect.

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How the Affordable Care Act Could Affect MA Residents

Medicaid Rolls to Expand

Changes for Employers

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