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Young and Uninsured Academy Health National Health Policy Conference. February 4, 2008. What I’ll cover. Summary of the Massachusetts Health Reform Law. Focus on young adults. Enrollment so far. The Mass. Health Reform Law. Became law on April 12, 2006.

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Presentation Transcript
what i ll cover
What I’ll cover
  • Summary of the Massachusetts Health Reform Law.
  • Focus on young adults.
  • Enrollment so far.
the mass health reform law
The Mass. Health Reform Law

Became law on April 12, 2006.

6.4 to 10.7% of MA uninsured in 2005/06:

  • 395,000(MA Div. of Health Care Finance and Policy).
  • 532,000(Urban Institute for BCBS of MA Foundation).
  • 618,000(U.S. Census Bureau).

Expanded Medicaid.

Created new subsidized and unsubsidized health plan options.

the mass health reform law1
The Mass. Health Reform Law

First “individual mandate” in the U.S.

7/1/07: Legal requirement to have insurance.

12/31/07: Must be insured on this date to avoid loss of MA personal exemption (worth $219).

1/1/08 - : New month-by-month penalties based on

½ the monthly premium of lowest-cost Health Connector option for the individual.

Sample penalties for those above 300% FPL:

Age 27 up: $72/month, or $912/year.

Age 18-26: $56/month, or $672/year.

the mass health reform law2
The Mass. Health Reform Law

The Commonwealth Health Insurance Connector Authority:

  • Regulates. (What’s affordable? What should health insurance cover…?)
  • Subsidizes.Commonwealth Care (“CommCare”) insurance for Mass. adults (19+) at or below 300% of FPL ($30,636 for an individual, $61,956 for family of 4, etc.).
  • Enterprises. Negotiates with carriers to offer new Commonwealth Choice (“CommChoice”) plans in the commercial market. Provides marketplace, tools and support for consumers.
the mass health reform law3
The Mass. Health Reform Law

Employers of 11 or more FTE’s:

  • Offer tax-free savings on premiums (Section 125 Plans) or risk surcharge when employees and/or dependents use Safety Net Care (a.k.a. “free care”).
  • “Fair and reasonable” health benefits or pay into Safety Net (care for uninsured).
  • And more…
how s it going
How’s it going?

300,000+ newly insured on or before 1/1/08.

  • 70,000 new Medicaid enrollees.
  • 169,000 in CommCare (Health Connector subsidized plans).
  • 16,000 in CommChoice (Health Connector unsubsidized plans).
  • 47,000 people newly enrolled in private health plans outside of CommChoice (and beyond ordinary growth projections) through 10/1/07.
the law and 18 26 year olds
The Law and 18-26 year-olds

Dependent coverage for 2 years following the loss of dependent status on taxes, up to age 26.

New “carve-out” – Young Adult Plans for 19-26 y-o* in the commercial marketplace:

  • Rx not required.
  • Purchase through the Health Connector (Commonwealth Choice) only.
  • Don’t have an employer-subsidized option.

*(Amended in 12/07 to include 18 year-olds)

mass young adult facts
Mass. Young Adult Facts

Uninsured rate for 18-26 year-olds*:

  • 25.4% (191,255) in 2004.
  • 18.9% (142,312) in 2006.

Enrollment of people age 18-26 in Health Connector programs (as of 1/1/08):

  • 46,465 in CommCare, or 29.4% of all enrollees.
  • 4,232 in CommChoice, or 26.5% of all enrollees.
  • Other sources…?

* Estimates calculated from Massachusetts Div. of Health Care Finance and Policy data.

young adults 2008 outreach plans
Young Adults: 2008 Outreach Plans

Research:

focus groups, survey.

Partnerships:

Red Sox, MBTA, Registry of Motor Vehicles, CVS, tax preparers, ZipCar, colleges and universities, more.

Ads/Media:

TV, radio, print, and web (including social networking sites).

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