Health Insurance Laws in MA

Massachusetts overhauled its health care system in 2006 under Gov. Mitt Romney. The law created Commonwealth Care, a new free or low-cost state insurance program for the low-income uninsured, and the Commonwealth Health Connector, an independent state agency that helps residents find health coverage. Massachusetts currently has the highest rate of insured residents in the nation. Between June 2006 and March 2008, 159,000 residents gained employer-based health coverage, according to the Commonwealth Health Insurance Connector Authority.

Who Must Obtain Coverage?

• Since 2007, all Massachusetts residents must be covered.

  Since July 2007, all state residents must obtain health coverage if it is determined that people in their income bracket can afford insurance. The Division of Health Care Finance and Policy report published in October 2009 showed that nearly three percent of residents were uninsured as of spring 2009.

Key Provisions of the Law

• Residents who earn less than 300 percent of the Federal Poverty Level can receive subsidized health insurance; low-cost insurance is available for other residents who don't receive insurance through their employers. Adult children can remain on their parents' plan for two years after the loss of dependent status under IRS rules or until age 26, whichever comes first. The law increases the enrollment cap on state health programs for the unemployed, people with disabilities and HIV programs.The maximum penalty for not carrying health coverage in 2010 is $93 for each month a person does not have coverage, for a total of $1,116 a year or half the cost of the lowest available yearly premium. Low-income residents are not required to buy insurance.

Small Business

• Companies with 11 or more full-time equivalent workers must offer employees health coverage or face a penalty under the law. For large firms the penalty is $2,000 for every employee over the first 30 that the firm employs. Businesses with 50 or fewer employees and individuals can buy coverage with pre-tax dollars directly. Employees offered health benefits through an employer can only buy coverage in the state insurance exchange if the coverage fails to meet the minimum standards and the plan premiums cost the employee more than 9.5 percent of his income.

Immigrants

• Massachusetts provides subsidized health coverage to legal immigrants.

  Subsidized health insurance is available to legal immigrants, but state budget shortfalls have led lawmakers to scale back legal immigrant coverage.

New State Insurance Programs

• The law established the Commonwealth Care Health Insurance Program, which provides sliding-scale, subsidized coverage for uninsured individuals who earn above 150 percent of the poverty line; the plans have no deductibles and no premiums if a person's income falls below 150 percent of the poverty line. It also established Commonwealth Choice, private health plans available to people who don't qualify for a state subsidy and a lower priced Young Adults Plan offering for individuals between the ages of 18 and 26.