SENATE DOCKET, NO. 1349        FILED ON: 1/16/2015

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 595

The Commonwealth of Massachusetts

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PRESENTED BY:

Patricia D. Jehlen

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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:

The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:

An Act to preserve affordable health coverage for Massachusetts residents.

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PETITION OF:

SENATE DOCKET, NO. 1349        FILED ON: 1/16/2015

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 595

The Commonwealth of Massachusetts

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In the One Hundred and Eighty-Ninth General Court
(2015-2016)

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An Act to preserve affordable health coverage for Massachusetts residents.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
 

SECTION 1. Section 9 of chapter 118E of the General Laws, as appearing in the 2012 Official Edition, is hereby amended by inserting, after the word "office" in line 39, the following:-

Enrollees with a household income that does not exceed 100 per cent of the federal poverty guidelines shall only be responsible for copayments equal to those required of enrollees in the MassHealth program. No other deductible or cost sharing shall apply to these enrollees. Enrollees with income that does not exceed 150 per cent of said guidelines shall have available to them at least one plan with no premium contribution.

SECTION 2. Section 3 of chapter 176Q of the General Laws, as so appearing, is hereby amended by striking out clause (b) and inserting in place thereof the following:-

(b) to determine each applicant's eligibility for purchasing insurance offered by the connector, and to establish eligibility criteria and determine eligibility for premium assistance payments or point of service cost-sharing subsidies for applicants at or below 300 per cent of the federal poverty guidelines, provided that individuals receiving premium assistance payments or point-of-service cost-sharing subsidies whose household income does not exceed 100 per cent of the federal poverty guidelines shall only be responsible for copayments equal to those required of enrollees in the MassHealth program, and no other deductible or cost-sharing shall apply to these enrollees; provided further that individuals receiving premium assistance or point-of-service cost-sharing subsidies with income that does not exceed 150 per cent of said guidelines shall have available to them at least one plan with no premium contribution; provided further  that for individuals not described above receiving premium assistance payments or point-of-service cost-sharing subsidies whose household income does not exceed 300 per cent of the federal poverty guidelines, premium contributions shall be on a sliding scale based on income; provided further, that premiums shall not exceed those at levels established in the enrollee premium contribution schedule for 2015, with adjustments by a reasonable inflation factor; provided further that plans offered to individuals whose household income exceeds 100 per cent of the federal poverty guidelines but does not exceed 200 per cent of the federal poverty guidelines shall meet 97 percent actuarial value, provided further that plans offered to individuals whose household income exceeds 200 per cent of the federal poverty guidelines but does not exceed 300 per cent of the federal poverty guidelines shall meet 95 percent actuarial value.