HCN News & Notes

Pilot Expansion of ConnectorCare Reshapes Affordability, Plan Options

BOSTON — The Massachusetts Health Connector board of directors have approved regulatory changes that will expand access to the marketplace’s landmark ConnectorCare program through a two-year pilot program, creating the opportunity for tens of thousands of people to access more affordable healthcare. The ConnectorCare program is currently available for people who make up to 300% of the federal poverty level (FPL) and do not have access to health coverage, such as through an employer.

The regulatory changes were required after Gov. Maura Healey signed the FY 2024 state budget, which included expanding the income limits of ConnectorCare from 300% of the FPL to 500% and all marketplace carriers to participate in the program for the first time. Together, the changes mean more residents than ever before will qualify for more help lowering healthcare costs since the creation of the Health Connector in 2006 and will also have greater access to more plan options.

“Health care affordability is essential for everyone in Massachusetts, but particularly for low- and moderate-income families. Expanding ConnectorCare means delivering real help to tens of thousands of people,” Healey said. “This is an impactful step in addressing affordability and maintaining the highest percentage of healthcare coverage in the country, and we appreciate our partners in the Legislature for making this effort a priority. We look forward to working with them to further increase access to affordable and quality healthcare.”

The ConnectorCare program started in 2014 to deliver Affordable Care Act benefits to Massachusetts residents, replacing the Commonwealth Care program launched with the Health Connector’s creation in 2006. Using federal advance premium tax credits and additional state funding, ConnectorCare provides help paying for premiums and co-pays on an income-based scale. It also includes no deductible payments for members.

“Raising the income limit for ConnectorCare creates the largest expansion in healthcare affordability since the Health Connector was created in 2006,” said Audrey Morse Gasteier, executive director of the Massachusetts Health Connector. “This extension of ConnectorCare means people can access plans that deliver important benefits, while saving thousands of dollars a year on the cost of healthcare.”

The new expansion to 500% of the FPL increases limits to $72,900 for an individual and $150,000 for a family of four. The changes will provide cost savings to more than 50,000 people. This includes current Health Connector members who earn between 300% and 500% of the Federal Poverty Level, as well as people who are transitioning from MassHealth, have applied for Health Connector plans in the past and did not qualify for subsidy, or are new applicants.

Along with extending income eligibility, all carriers who participate in the marketplace will offer plans in ConnectorCare. Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim Health Care, and UnitedHealthcare join current participating carriers Fallon Health, Health New England, Mass General Brigham Health Plan, Tufts Health Plan, and WellSense Health Plan.

Newly qualified and current Health Connector members will be automatically enrolled in ConnectorCare and retain their current carrier. Changes go into effect for 2024 plans, and Open Enrollment for next year starts on Nov. 1.