Massachusetts Health Insurance Connector Considers Expanding State-Subsidized Coverage to Low-Income Residents Who Cannot Afford Employer-Based Coverage

Between 30,000 and 40,000 Massachusetts residents are offered health insurance by their employer but have incomes less than 300% of the federal poverty level and cannot afford the premiums, according to a report released Thursday by the Commonwealth Health Insurance Connector, the Boston Globe reports.

According to the Massachusetts Health Insurance Law of 2006, which established a statewide individual insurance mandate, low-income residents who are not offered insurance by their employers can enroll in state-subsidized Commonwealth Care plans. The law also gives the Connector authority to cover low-income residents whose employers offer coverage. The state Legislature last year directed the Connector to determine how many people would fall into that group and how much it would cost to cover them.

Expanding the program to cover such people could cost more than $250 million within a few years, according to the Globe. Bob Carey of the Connector board said the move likely would result in 10% of qualifying workers enrolling in the subsidized plans each year.

Determining how to pay to expand the program will be "daunting" for officials, the Globe reports. State Secretary of Administration and Finance Leslie Kirwan in March estimated that the program would cost more than the $869 million proposed by Gov. Deval Patrick (D) for fiscal year 2009, and an information statement issued in April to bond rating agencies estimated the cost of the program would be $1.1 billion in FY 2009.

The coverage expansion could present other challenges, including that it might encourage people to leave their employer-sponsored plans for state-subsidized coverage or prompt employers to offer less-attractive policies, which could push workers to enroll in state-funded policies, the Globe reports.

Connector Executive Director Jon Kingsdale said that covering workers unable to afford employer-based health coverage is central to the agency's mission of guaranteeing that every state resident has health insurance (Krasner, Boston Globe, 5/9).