Pilot Will Extend ConnectorCare Coverage To 50,000

Program Expansion Comes As MassHealth Reduces Enrollment

STATE HOUSE, BOSTON, AUG. 14, 2023…..An estimated 50,000 people on Monday became newly eligible for ConnectorCare health insurance, which the state advertises as offering “$0 or low monthly premiums, low out-of-pocket costs, and no deductibles.”

The Massachusetts Health Connector Board of Directors unanimously approved regulatory changes required in the $56 billion fiscal 2024 state budget that Gov. Maura Healey signed last week to expand access to the low-cost insurance program.

Lawmakers included in the budget a two-year pilot program to expand the income limits for ConnectorCare from 300 percent of the federal poverty level to 500 percent. An individual making 500 percent of the federal poverty level has an annual income of $72,900, and a family of four brings in $150,000, according to the U.S. Department of Health and Human Services.

Audrey Morse Gasteier, executive director of the Massachusetts Health Connector, said a newly eligible individual making close to the new limit could save up to $4,000 on health care costs each year by opting into the program now available to them.

This is the first time since the Connector was created in 2006 that the state has expanded state-level subsidy support for residents, Gasteier said Monday.

“The Connector’s mission, of course, is to make health care as affordable as possible for as many people as possible,” Gasteier said. “And this mission is especially critical right now for two reasons: one, we are facing down the largest coverage transition, the ongoing Medicaid redetermination process, that our market has seen in a decade or more. And further, two: we continue to see health care affordability challenges strain ever more household budgets, threatening access to care and financial security.”

The pilot could provide a new option for some Bay Staters who lose MassHealth coverage amid a massive, year-long campaign to trim enrollment for the first time since the pandemic began. Officials have estimated the redetermination process could shrink the MassHealth rolls by up to 400,000 people, who will need to get coverage elsewhere.

Gasteier said the estimated 50,000 newly eligible Bay Staters is a moving target as the redetermination process plays out over the year.

In order to be eligible for ConnectorCare insurance, a resident must not have access to affordable, employer-sponsored insurance, the executive director said.

The pilot program will begin on Jan. 1, 2024.

Andrew Egan, general counsel at the Health Connector, said because of immediate action required to prepare for a January start date, there is not enough time for a normal regulation amendment process.

“We need to begin program determinations that will take effect on January 1 this month — really, tomorrow,” Egan said.

The regulatory changes were approved on an emergency basis, and over the next three months the Health Connector will hold a public hearing on the amendments, and changes will be brought back before the board for an additional vote.

“What our system will do for the tens of thousands of people… our system will send an automated notice to them saying, congratulations, you just became ConnectorCare eligible, even if nothing changed in their household circumstance, their income or the rest,” Gasteier said. “So they will be communicated to immediately and then they will start to get messages from the Connector about what that means.”