[Massachusetts] Weighs Low-Income Health Plan Payments

from Insurance Journal

Low-income residents would pay between $10 and $100 a month for health care under draft regulations set to be reviewed by the board overseeing the state's sweeping new insurance law.

Under the draft regulations, single adults living at the annual federal poverty level of about $9,800 would be required to make a monthly health care contribution of $10 or about 1 percent of their income. Couples would pay $20.

Single adults making up to three times the poverty level, or just under $30,000, would be required to pay $100 a month, or about 4.5 percent of their income, with couples paying $200, about 6.6 percent of their income.

Low income residents would also be offered low cost premiums under the plan.

Those making less than the federal poverty level would pay nothing for most medical services, from office visits to ambulance services and dental care.

Those making between two and three times the poverty level would be offered two insurance options, a lower premium/high cost-sharing plan or a higher premium/lower cost-sharing program.

They would also be required to pay for most medical services, from $100 for outpatient surgery to up to $40 for a month's supply of prescription medication from pharmacies. The proposal sets a cap of $500 for inpatient surgery.

The plan is set to be discussed Thursday at a meeting of the Health Care Connector Board, charged with setting policies for the state's new health care law.

The law, passed last April, would require everyone in Massachusetts be insured by July 2007, providing subsidies and sliding-scale premiums to get poor and low-income residents into health plans.

Those deemed able to afford insurance but who still refuse will face increasing tax penalties.