Amendment #135 to H4000

Health Care Affordability Protections for Low-Income Residents

Representatives Balser of Newton, Andrews of Orange, Benson of Lunenburg, Decker of Cambridge, Fox of Boston, Khan of Newton, Malia of Boston, Rushing of Boston and Toomey of Cambridge move to amend the bill by adding the following sections:–

“SECTION X. The third paragraph of section 9 of chapter 118E of the General Laws is hereby amended by adding the following sentences:-  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 premium, deductible, or other cost sharing shall apply to these enrollees. Enrollees with income that is over 100 percent of said poverty guidelines but that does not exceed 150 per cent of said guidelines shall have available to them at least one plan with no premium contribution.

SECTION X. Section 3 of chapter 176Q of the General Laws 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 other cost sharing shall apply to these enrollees; provided further that individuals receiving premium assistance or point-of-service  cost-sharing subsidies with income that is over 100 percent of said poverty guidelines but that does not exceed 150 per cent of said guidelines shall have available to them at least one plan with no premium contribution.”