December 4, 2017

Column: Facing hikes, many exchange shoppers should look elsewhere

Over the last decade, Massachusetts has proven to be the nation's leader in healthcare, with the highest coverage rate in the country, and an enduring commitment to making sure everyone has access to care.

In the last year, that commitment has held steady, even as the national conversation on health care has shifted. Governor Baker and other Massachusetts leaders remain committed to protecting the Commonwealth's achievements. However, many people will not be immune to the changes happening nationally.

Last month, the federal government announced that it would stop making payments to health insurers that help make it less costly for lower-income people to access health care, something insurers are required to do. These payments, called Cost Sharing Reductions, help maintain a stable market with affordable coverage for those who need help paying for their insurance.

To fill the gap created by the federal government's decision, premiums for 2018 plans in the Health Connector's ConnectorCare program, which provides subsidies to qualified residents seeking coverage, have increased. This ensures that the state's market remains stable, with carriers receiving the funding they need to help keep access to care affordable for lower-income residents. It also ensures that ConnectorCare members are held harmless as increased premium tax credits cover the increased premium.

Unsubsidized to feel hikes

However, there are up to 70,000 people in Massachusetts who are in these impacted plans and yet do not receive subsidies. They are on the hook for the entire increase in their premium for next year, which -- at 25 percent or more -- is a substantial hardship for many families

For people looking at these increases, now is the time to shop for a new plan. Open Enrollment started Nov. 1, and this is the time when everyone who does not get their insurance from their job (or from Medicare or Medicaid) should consider the best plans for their needs for next year. But especially for those 70,000 Massachusetts residents facing big increases as a result of the federal government's action, it is imperative to take action before the Dec. 23 deadline for the New Year.

These members have two options: One is to shop for a new plan on the Health Connector. The majority of unsubsidized plans available through the Health Connector are unaffected by this premium increase, so shopping for a new plan pays off.

Buy direct

This year, we have made another option available to members – to shop directly from their current carrier. Members can go off-Exchange and purchase essentially the same plan directly from their carrier at a lower premium.

The Health Connector is designed to be an easy place for Massachusetts residents to come and compare plans and select coverage. The primary objective, however, is to ensure these 70,000 people have coverage, whether it is through the Health Connector or through a carrier, so the Health Connector is working closely with its carriers to create the easiest plan selection and transition process possible.

Regardless of the political debates taking place in Washington D.C., the Commonwealth remains committed to providing healthcare access to everyone. There will be challenges to stay true to this commitment, but over the last decade Massachusetts has proven to be up to the task of finding the path forward. As the national healthcare conversation presses on, Massachusetts will remain a leading voice in the discussion and continue to fight for the best interests of the health care of its residents.

Louis Gutierrez is the executive director of the Massachusetts Health Connector, the state insurance exchange.


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