Last night we partied like it’s FY 2009, and today starts a new state fiscal year. There’s no budget and no waiver (both have short extensions), but for low-income Bay Staters there are increases in Commonwealth Care premiums and co-pays, starting today.
The Connector Board voted on these increases in March in response to financing concerns. With enrollment higher than expected, and with a greater percentage of enrollees in the fully-subsidized income category, the cost to the state is higher than originally projected. In an effort to help close that funding gap, the state looked first to the low-income enrollees for additional funds.
The monthly premiums for the lowest-cost partially-subsidized Commonwealth Care plans are increasing by 10% (from $35 to $39, from $70 to $77, and from $105 to $116); many co-pays are increasing as well, some by 100%. For the new premium and cost-sharing, see the Connector’s website (copays here; and premiums here (.xls)). Those between 100%-150% of the poverty level (about $10,400-$16,600 annual income for an individual) will now have to pay premiums if they pick a plan other than the cheapest in their region.
The copay increases will hit the sickest members. There’s increasing evidence that even modest copays, particularly for low-income people, discourage needed care. We urge the Connector and the health plans to carefully monitor people to make sure that necessary care is provided.
Today is also the close of a six-week long open-enrollment period—combined with significant outreach on behalf of the Connector and the MassHealth outreach grantees—designed to educate consumers about the premium increases and what is available to them in their region. Commonwealth Care members now have an additional 60 days to switch plans.
When the Connector voted on these increases, consumers and advocates understood that while enrollees were the first among many stakeholders to pony up more money for health reform, they would not be the only. As we understand better how much money we need to fill the health reform gap, we now look to the other stakeholders at the table to help fill it.
Lindsey Tucker
