It was in early 2021 that Congressional Democrats passed & President Biden signed the American Rescue Plan Act (ARPA), which among other things dramatically expanded & enhanced the original premium subsidy formula of the Affordable Care Act, finally bringing the financial aid sliding income scale up to the level it should have been in the first place over a decade earlier.
In addition to beefing up the subsidies along the entire 100 - 400% Federal Poverty Level (FPL) income scale, the ARPA also eliminated the much-maligned "Subsidy Cliff" at 400% FPL, wherein a household earning even $1 more than that had all premium subsidies cut off immediately, requiring middle-class families to pay full price for individual market health insurance policies.
Here's what the original ACA premium subsidy formula looked like compared to the current, enhanced subsidy formula:
Health Connector member survey finds 88 percent have used new coverage, one in five have used preventative services previously deferred
August 28, 2024 – A new report published today by the Health Connector shows that the ConnectorCare pilot expansion enabled access to lower-cost health insurance to over 51,000 Massachusetts residents and many new participants benefit from the program’s financial protections.
The pilot expansion, part of the Fiscal Year 2024 state budget, is available to residents for Calendar Years 2024 and 2025. The expansion lifted income eligibility limits to the program from 300 percent to 500 percent of the federal poverty level – from $43,740 to $72,900 for an individual, and from $90,000 to $150,000 for a family of four.
Massachusetts, which is arguably the original birthplace of the ACA depending on your point of view (the general "3-legged stool" structure originated here, but the ACA itself also has a lot of other provisions which are quite different), has 9 different carriers participating in the individual market in 2025. This is down from ten this year--ConnectiCare appears to be dropping out of the Massachusetts market.
One thing which sets Massachusetts (along with Vermont) apart from every other state is that their Individual and Small Group risk pools are merged for premium setting purposes.
Normally you would think this would make my job easier, since I only have to run one set of analysis instead of two...but until recently, it was surprisingly difficult to get ahold of exact enrollment data for each carrier on the merged Massachusetts market (and even more difficult to break out how many are enrolled in each market since they're merged...not that that's relevant to the actual rate changes).
The Massachusetts Health Connector is celebrating today’s 18th anniversary of health care reform in Massachusetts, highlighting all-time high enrollment in health and dental plans, and providing health insurance to more than 1.1 million Massachusetts residents since 2015.
Today, 350,000 Massachusetts residents get their health or dental coverage (or both) through the Health Connector, the most in the Marketplace’s history. This includes more than 250,000 in ConnectorCare coverage, the Health Connector’s landmark subsidized health insurance program.
Massachusetts Health Connector ends busiest Open Enrollment in a decade with more than 72,000 new enrollments
Marketplace enrollment increases dramatically by 40 percent in the last year
BOSTON – More than 72,000 people enrolled in new health insurance plans with the Massachusetts Health Connector during Open Enrollment 2024, which ended on January 23. This is the largest number of new enrollments in a decade, continuing a rapid increase in overall Health Connector enrollment, which has surged by 40 percent in the last year.
Note: as the next paragraph states, the 40% increase refers to total effectuated enrollment as of today versus total effectuated enrollment as of February 2023. When you include total QHPs and divide it last open enrollment periods total QHPs, which is my and CMS's standard methodology, it's a 30% year over year increase. I've been informed that there are an additional 7,713 enrollees who haven't actually paid their first premium yet.
The deadline for coverage beginning January 1 is December 23, 2023, but residents have until January 23 to apply for 2024 coverage
BOSTON, November 1, 2023 – Open Enrollment for 2024 health plans through the Massachusetts Health Connector starts today, with expanded access for tens of thousands of newly-eligible Massachusetts residents to the landmark ConnectorCare program that already helps 156,000 people access more affordable coverage.
Open Enrollment is when anyone who needs health insurance can find coverage through the Health Connector, the Commonwealth’s official health insurance Marketplace. Open Enrollment runs through Jan. 23, but the deadline to start the New Year with coverage is Dec. 23. People who need health insurance can go to MAhealthconnector.org to apply and enroll in coverage. They can also find community-based support in dozens of languages to assist with completing an application.
Exciting news: Massachusetts is making health care more affordable and accessible for thousands of people through the ConnectorCare program. The Massachusetts Health Connector Board of Directors has approved important changes to help more people get the care they need. Here’s what you need to know:
Massachusetts, which is arguably the original birthplace of the ACA depending on your point of view (the general "3-legged stool" structure originated here, but the ACA itself also has a lot of other provisions which are quite different), has 10 different carriers participating in the individual market.
One thing which sets Massachusetts (along with Vermont) apart from every other state is that their Individual and Small Group risk pools are merged for premium setting purposes.
Normally you would think this would make my job easier, since I only have to run one set of analysis instead of two...but until recently, it was surprisingly difficult to get ahold of exact enrollment data for each carrier on the merged Massachusetts market (and even more difficult to break out how many are enrolled in each market since they're merged...not that that's relevant to the actual rate changes).
OK, after several weeks of this site turning into AnnualRateFilingsDotCom, I'm finally catching up on some other important ACA/healthcare-related developments which are happening.