MassHealth Review Sparks Interest In Connector Plans

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BOSTON (State House News Service) - With open enrollment underway for the state's health insurance marketplace, significantly more people are now seeking coverage through the Massachusetts Health Connector clearinghouse compared to this point last year.

More than 50,000 people have enrolled in plans available through the Connector after losing coverage amid the state's massive year-long effort to redetermine eligibility for 2.4 million MassHealth members. The evolving insurance landscape has translated into a 25 percent jump in Health Connector enrollment this year, Audrey Morse Gasteier, executive director of the Health Connector, said Thursday.

"This is easily the most important open enrollment for the Health Connector in a decade," Gasteier said at a Connector board meeting. "We will continue to make sure that the Health Connector remains highly visible throughout the open enrollment period, particularly in mid-December as we get up to the big Dec. 23 enrollment and payment deadline for people to sign up for coverage to start the new year."

The Connector helps individuals, families and small businesses compare and enroll in affordable coverage through major health and dental insurance providers. The marketplace boasts about 300,000 members, including individuals and small businesses, officials said earlier this month.

Officials are focused on about 60,000 people who are eligible for Health Connector plans and need to enroll to avoid a gap in coverage once they no longer qualify for MassHealth, said Marissa Woltmann, chief of policy at the insurance exchange.

There's been higher than average enrollment among Connector members who have relied on assistance, such as application counselors and navigators who provide one-on-one guidance for people as they explore their eligibility and enrollment options, Woltmann said.

"We're seeing strong enrollment among populations who prefer a language other than English, and this is especially true when they have an assister," Woltmann said. "We're talking to some of the assisters in both high- and lower-performing communities to gather qualitative data about what's working, and what barriers remain, and then how we can share those lessons learned."

Woltmann said the Health Connector's outreach efforts are also effective, with officials seeing a correlation between more paid media advertising and higher enrollment numbers.

About 2,500 people who are between 300 to 500 percent of the federal poverty line have selected a plan or enrolled in an expanded ConnectorCare plan, Gasteier said.

The board approved permanent updated regulations Thursday to launch the two-year pilot program, which the Legislature approved in the fiscal 2024 budget, to expand the income limits for heavily subsidized ConnectorCare coverage and help more low-income Bay Staters access coverage if they are no longer eligible for MassHealth. ConnectorCare coverage offers members "$0 or low monthly premiums, low out-of-pocket costs, and no deductibles," according to state advertising.

Insurers who provide plans through the Health Connector will also offer ConnectorCare plans. The list of carriers includes Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim Health Care, UnitedHealthcare, Fallon Health, Health New England, Mass General Brigham Health Plan, Tufts Health Plan, and WellSense Health Plan.

MassHealth has so far worked through nearly 1 million renewals and eligibility determinations since April, said Elizabeth Denniston, MassHealth's chief of staff. About 76,000 members have been removed from MassHealth rolls as of Oct. 20, though officials say larger disenrollments are expected this fall and winter.

The MassHealth rolls are expected to drop by a net 300,000 to 400,000 members, the Healey administration has said. The redetermination process is expected to save the state $1.9 billion in fiscal year 2024.

About 14 percent of people eligible for a Health Connector plan so far have said they have access to another type of insurance coverage, such as through their employers, Woltmann said.

Health and Human Services Secretary Kate Walsh said she's concerned about MassHealth members who have transitioned to commerical insurance coverage. She suggested the "next frontier" for health officials is to examine the plans offered by employers and gauge whether the Health Connector needs to fill a gap with a lower-cost product.

"If you go from MassHealth to a high-deductible product and you're low- or middle-income, you're functionally uninsured," Walsh said. "I'm a little worried that people might feel they have similar coverage and they don't for higher price medicines, or co-pays and deductibles that they've never had to experience."

While former MassHealth members are expected to shop for various insurance plans, Woltmann said the Health Connector intends to continue its outreach efforts to ensure residents can access coverage.

"We do know, though, that it's been challenging for people to go from no-premium MassHealth to a Connector plan premium," she said. "So we're working to make sure that everyone's aware of what the premiums are in ConnectorCare, rather than assuming they're unaffordable, and that there are premium waivers available for ConnectorCare members who are experiencing extreme financial hardships."

Written By Alison Kuznitz/SHNS

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