Creates a new Health Care Access Bureau within the Division of Insurance with responsibility for oversight of the small group and individual health insurance market and affordable health plans, funded by a $600,000 annual assessment on insurance carriers.
Creates an Essential Community Provider Trust Fund. Funds will be used to make grant payments to hospitals and community health centers in accordance with criteria established by the new Health Safety Net Office.
Establishes the procedure for implementation of the individual mandate. Qualifying individuals for whom "creditable coverage" is deemed affordable must have "creditable coverage" in place. Individuals must include information about health insurance status on their tax forms. Failure to meet the insurance requirement will result in a penalty, assessed by the department of revenue. All penalties will be deposited in the Commonwealth Care Trust Fund that will contribute to state subsidies for the Commonwealth Care program. • Creates a penalty for non-compliance with the individual mandate as equal to 50% of the lowest premium available for each month the individual did not have creditable insurance, as determined by the Connector.
Expands employee eligibility for participation in the Insurance Partnership Program to 300% of the Federal Poverty Level. • Ensures that Insurance Partnership subsidies are consistent with those provided under the Commonwealth Care program. • Specifies that self-employed individuals enrolled in the Insurance Partnership Program are eligible for employee subsidies only.
Creates Health Safety Net Office to replace current Uncompensated Care Pool administration. The Health Safety Net pays acute care hospitals and community health centers for certain essential services provided to uninsured and underinsured Massachusetts residents.