Massachusetts Offers Exemptions to Health Insurance Mandates

Individual or Family Health
Group Health Coverage

Massachusetts Offers Exemptions to Health Insurance Mandates

Some opponents to the mandated health insurance about to be implemented in Massachusetts and proposed in several other states objected to the idea of a mandate that forces people to purchase something they may not be able to afford. Advocates never felt that was a valid objection, confident that when the plan was actually put into effect, exemptions to the requirement would be built in, so the programs does not cause hardship to any family or individual. This has proven to be the case.

The Commonwealth Insurance Connector has approved a proposal that will exempt about 20% of the states uninsured from the health insurance requirement that was put into effect last year. Under the law those who do not obtain heath insurance face fines and penalties. But the new proposal exempts those who cannot afford to purchase private health insurance. It will be up to the Connector to determine the definition of “afford”. The Boston Globe estimates that the proposal will likely affect about 60,000 low to moderate income residents of the state who do not qualify for State subsides, or approximately 1% of the total population.

The proposal stipulates that an individual making up to $40,001.00 per year should only have to pay up to 9% of their income to obtain quality health insurance or about 300.00 per month. Those with an income level less than $25,000.00 would only have to pay about 3% or 70.00 monthly. The proposal extends state sponsored no cost health insurance to all individuals making less than $15,315.00 and to any family whose total income is below $30,630.00. The program also extends state subsidies to 52,000 of lowest income families who currently qualify for Commonwealth Care.

The key to the new proposal is that while individuals making between $30,630 – 50,001.00 would not qualify for any kind of supplemental help from the state, they will be exempt from tax penalties or fines if they prove they are unable to obtain health insurance for less than $150.00 - 300.00 per month. State officials say that the changes will likely increase cost estimates for the first year of the program about 12 million dollars, but they feel the changes are necessary and will be able to draw the additional funds from monies that were previously apportioned to hospitals to provide charitable care for the uninsured.

Reaction to the new proposal has been mixed, but most feel that it represents a good compromise between those that felt broad exemptions were needed, and those that felt that the majority of folks could afford to purchase low-cost health insurance under the original proposal. Advocacy groups say the plan does not quite go far enough for low and moderate income families, but for the most part they are pleased with the proposal. Says John McDonough, Executive Director of Health Care for All in a recent interview with the NY Times, "It doesn't go the whole way, but it's good enough for today, I know there's a lot of trash talk around the country about, 'Oh it's falling apart in Massachusetts.' It ain't true. We are going to be far and away the state with the lowest number of uninsured by a country mile"