SENATE DOCKET, NO. 1583        FILED ON: 1/20/2017

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 630

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 restore affordable Health Connector coverage.

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PETITION OF:

SENATE DOCKET, NO. 1583        FILED ON: 1/20/2017

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 630

[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE SENATE, NO. 595 OF 2015-2016.]

The Commonwealth of Massachusetts

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In the One Hundred and Ninetieth General Court
(2017-2018)

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An Act to restore affordable Health Connector coverage.

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 2014 Official Edition, is hereby amended by inserting after the word “office.”, in line 45, 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, cost sharing or premium 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 clause:-

“(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 premium, 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 2016, 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.”