FILED ON: 7/28/2022

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 5123

The Commonwealth of Massachusetts

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In the One Hundred and Ninety-Second General Court
(2021-2022)

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An Act authorizing the Health Insurance Connector Authority to implement a 2-year pilot program to extend eligibility for premium assistance payments or point-of-service cost-sharing subsidies for certain applicants.

Whereas, The deferred operation of this act would tend to defeat its purpose, which is to  authorize the Health Insurance Connector Authority to implement a 2-year pilot program to extend eligibility for premium assistance payments or point-of-service cost-sharing subsidies for certain applicants, therefore it is hereby declared to be an emergency law, necessary for the immediate preservation of the public convenience.
 

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.  (a) Notwithstanding clause (b) of section 3 of chapter 176Q of the General Laws or any other general or special law to the contrary, the commonwealth health insurance connector authority established in section 2 of said chapter 176Q shall implement a 2-year pilot program to extend eligibility for premium assistance payments or point-of-service cost-sharing subsidies for applicants at or below 500 per cent of the federal poverty guidelines.

(b)  Applicants participating in the pilot program that are between 300 and 500 per cent of the federal poverty guidelines shall have access to a plan that meets at least 90 per cent actuarial value; provided, that the affordability standard for the pilot program shall be consistent with current practices pursuant to said section 3 of said chapter 176Q.

(c)  Notwithstanding the second paragraph of section 2OOO of chapter 29 of the General Laws or any other general or special law to the contrary, amounts necessary to support the 2-year pilot program established in subsection (a) shall be expended from the Commonwealth Care Trust Fund established in said section 2OOO of said chapter 29.

(d)  The commonwealth health insurance connector authority, in consultation with the center for health information and analysis, shall evaluate the pilot program to assess the public health, health equity, utilization and financial impacts on residents of reducing out-of-pocket costs and premium costs. The center shall collect quantitative and qualitative data at the start of the pilot program and at the end of each year of the pilot program to assess the impact on pilot program participants. Data points to be collected shall include, but not be limited to: (i) rates of unmet medical need due to cost; (ii) disparities in rates of unmet medical need due to cost; (iii) difficulties accessing care at a doctor’s office or clinic; (iv) racial and ethnic disparities in difficulties accessing care at a doctor’s office or clinic; (v) insurance coverage rates, including rates of continuous insurance coverage; (vi) racial and ethnic disparities in insurance coverage rates; (vii) visits to a doctor’s office; and (viii) racial and ethnic disparities in visits to a doctor’s office. The connector authority shall file reports of its evaluation with the clerks of the house of representatives and the senate, the house and senate committees on ways and means, the joint committee on public health and the joint committee on health care financing not later than December 1, 2024 and December 1, 2025.

SECTION 2.  Section 1 shall take effect on June 1, 2023.

SECTION 3.  Section 1 is hereby repealed.

SECTION 4.  Section 3 shall take effect on May 31, 2025.

SECTION 5. This act shall take effect on July 1, 2022.