An estimated 50,000 individuals will be newly eligible for Massachusetts’ ConnectorCare program.
Massachusetts announced a two-year temporary expansion of the ConnectorCare program’s income eligibility limit, rising from 300 to 500 percent of the Federal Poverty Level (FPL). This shift allows for a substantial increase in the number of individuals benefiting from this program.
Governor Maura Healey signing of the Fiscal Year 2024 state budget sealed the funding for a two-year pilot program set to take effect on January 1, 2024.
“Health care affordability is essential for everyone in Massachusetts, but particularly for low- and moderate-income families. Expanding ConnectorCare means delivering real help to tens of thousands of people,” shared Governor Maura Healey.
The History of ConnectorCare: Innovative Programs for Hard-to-Reach Demographics
Massachusetts is no stranger to the innerworkings of the ACA Marketplace.
In 2006, the establishment of the Massachusetts Health Connector marked a significant milestone for state-based marketplaces (SBMs). Today, the state offers health and dental marketplace coverage to more than 300,000 individuals and small-employer members.
As a testament to its success, Massachusetts boasts the highest health insurance coverage rate in the nation. This rate is partially attributed to innovative and targeted programs like ConnectorCare.
ConnectorCare extends subsidized health insurance, catering to those not eligible for MassHealth or other public coverage, nor possessing an affordable employer-sponsored option. The program improves affordability by supplementing ACA subsidies with “state-wrap” subsidies.
ConnectorCare’s functional design is modeled after the Health Connector’s pre-ACA subsidy program, Commonwealth Care.
Now, Massachusetts is doubling down on its investment.
Technology’s Role in Accommodating Sudden Changes to Healthcare Policy
The program expansion required 10 months of technological planning before the 2024 State Budget was even approved. After the budget was signed, the Health Connector’s board had policies supporting the new program.
Alignment between politics, healthcare policy, and technology is needed to support the expansion.
But sudden policy changes back by flexible technology is not a new thing for Massachusetts.
During the COVID-19 pandemic, Health Connector enacted temporary policy changes to promote coverage and continuity of care. Between March 2020, and August 2020 Health Connector did not penalize anyone for failure to respond to a Request for Information, and it delayed April terminations due to nonpayment.
Rapid changes to daily processes like eligibility determinations, member noticing, plan design, and special enrollment periods are needed for a successful expansion of ConnectorCare.
The ConnectorCare expansion not only marks a new chapter in merging healthcare policy and technology but also highlights the benefits of transitioning to an SBM.
Health coverage needs to be personalized and address the unique needs of communities. Programs like ConnectorCare utilize the flexibility of the SBM framework to launch innovative programs that help state residents. Moreover, having a shopping and enrollment infrastructure tailored to the state’s requirements, as opposed to the one-size-fits-all approach of the Federally Facilitated Marketplace, ensures swift adjustments to support policy shifts.
The combination of policy and technological flexibility can rapidly transform theoretical concepts into tangible real-world impacts.
If you have any questions or would like to discuss who some states adopt state-based marketplaces, feel free to reach out to the author of this blog at Jschultz@softheon.com.