Fact Sheet
What is the number of people your plan would cover, or the percentage of the uninsured your plan would cover? By what date?
It would become the law in Massachusetts to have health insurance beginning January 1, 2007. We would expect almost all of the uninsured to have purchased private insurance within two years.
Are residents required to purchase insurance, and how does
the
mandate work?
Yes. Exceptions would be those who choose to pay their own medical expenses out of pocket, but they would have to demonstrate their ability to pay by posting a $10,000 bond. Failure to comply would result in the loss of the personal exemption on state tax returns. Offsets would be deposited into a Medical Escrow Account. Funds in those accounts would be available to pay bills to hospitals. Healthcare providers would also be able to institute wage attachments for unpaid bills.
Are employers required to provide insurance, and how does the mandate work?
No. However, the Governorfs bill makes it easier for businesses that do not offer insurance to do so through the creation of an Insurance Exchange that allows every employer to offer affordable, pre-tax insurance, whether they choose to contribute or not.
How will the state pay for your plan?
The plan will be financed from existing revenues sources. Specifically, funds already being spent to cover the uninsured and underinsured totaling more than $1 billion per year will be used to subsidize premiums for people who canft afford to pay. In addition, the Governor is investing more than $360 million of existing state and federal revenue to enroll people who are currently eligible for Medicaid but are not currently in the program.
What insurance plan(s) would you offer to the uninsured that don't qualify for Medicaid (e.g. do you propose a subsidized, low-cost insurance plan)?
For individuals earning $29,000 or more who lack insurance, we are proposing
to institute a Commonwealth
Care 
program that permits insurers to offer new, affordable polices to small
businesses and individuals. The estimated cost on a pre-tax basis is less than
$200 per month for an individual. These comprehensive policies would include
primary and preventive care, hospitalization, surgical procedures, prescription
drugs, and mental health benefits. Plans being suggested by the Insurance
industry suggest deductibles ranging from $250 to $1,000 and moderate co-pays
between $20 and $40 and directed provider networks.
Similar benefit policies would be available for lower income individuals
making less than $29,000, but they would be subsidized on a sliding scale based
on income through a program called Safety Net Care
. For example, a single person earning 100% of FPL, or $9,500,
would have a weekly premium of approximately $2.30 and the state would provide a
subsidy of approximately $66.93, or 97% of the plan cost. As you
make more, you pay more.
Most importantly, there would be lower co-pays and NO deductibles for members enrolled in Safety Net Care.
How many more people would be added to Medicaid under your plan, and how would we add them?
Last year, we identified approximately 106,000 Massachusetts residents who qualified for MassHealth, but were not currently enrolled in the program. The Administration has been enrolling this population for the past year. To date, we have enrolled approximately 50,000 of these eligible but unenrolled individuals.
How would your plan change the way the free-care pool works?
The free care pool, as it is currently structured, would cease to exist. Money normally channeled through it would be used to create subsidies for lower-income residents who do not qualify for MassHealth to purchase insurance. Recognizing that the transition from reliance on the pool to an insurance plan will require time, our plan calls for the establishment of the Safety Net Transitional Assistance Fund to provide free care for people who fall through the cracks.