Current Status in Establishing Exchange:
Declared State-based Exchange. Conducted an analysis of existing state benefit mandates, assessed benchmark plan options, held a public comment period, formed a workgroup on essential health benefits.
Regular legislative process.
- Massachusetts initially appropriated $25 million to operate the Connector, but is now financially self-sustaining to apply surcharge to all health benefit plans offered through the Connector. The Connector’s current operating budget is approximately $30 million. The collected funds pay for the Connector’s administrative and operational expenses, not premium assistance payments, under Commonwealth Care.
- A federal Exchange Planning grant of $1 million was give to the Massachusetts Commonwealth Insurance Connector Authority in September 2010.
- A Level One Establishment grant of $11.6 million was given to the Connector Authority, to analyze coverage transitions and the operational interface between the Exchange and the state’s Medicaid program, in February 2012.
- Massachusetts is a member of the consortium of New England States Collaborative Insurance Exchange Systems that received a federal Early Innovator grant of $36 million to develop, share, and leverage insurance exchange technology.19 The University of Massachusetts Medical School is the grant holder.
- A second Level One grant of $41.7 million was given to Massachusetts in September 2012, to create a risk-adjustment program and support IT development lead by the HIX/IES. The Connector is also working on components of a Level Two application, which will include projected operating costs for 2014.
· Small Group Plan
· EHB Benchmark Plan: Blue Cross Blue Shield of Massachusetts HMO Blue
· The Pediatric Dental Supplemental Plan: Commonwealth of Massachusetts Children’s Health Insurance Program (CHIP)
- In 2006, former Governor Mitt Romney led the state in comprehensive health reform which created the Massachusetts Health Connector, which is an insurance exchange. Governor Deval Patrick built on these reforms, including the authorization of the Connector to be certified as a state-based exchange under the ACA and operate as such.
- The Connector is governed by an 11-member Board and the Connector is certified as a state-based exchange as defined in the Affordable Care Act (ACA) and has the authority to perform key tasks, such as establishing a Navigator program and administering appeals related to the federal exchange. Current appointed Board Members are:
o Ian Duncan, Solucia Inc.
o George Gosner Jr, Spring Insurance Group
o Jonathon Gruber, Massachusetts Institute of Technology
o Andrés López, AJL Consultants
o Louis Malzone, Massachusetts Coalition of Taft-Hardly Funds
o Nancy Turnbull, Harvard School of Public Health
o Celia Wcislo, 1199 SEIU United Healthcare Workers East
- The state is planning an extensive education and outreach campaign to engage stakeholders.
For More Information: