ConnectorCare expansion casualty of chaotic session

BOSTON — A plan to dramatically expand state-subsidized health insurance coverage to tens of thousands of people has fallen victim to the chaotic end of the legislative session.

Approved by the state Legislature in the final days of its two-year session, the plan called for a two-year pilot program expanding eligibility for ConnectorCare, the state's subsidized health insurance program.

Under the proposal, beginning in July 2023 coverage would be offered to an estimated 37,000 individuals and families earning up to 500% of the federal poverty level, or about $139,000 for a family of four. The current level is 300% of the poverty level.

Gov. Charlie Baker sought to block the changes with an amendment to the state's $52.7 billion budget. He argued that the state needs more time to study the plan before moving ahead.

But the Democratic-controlled Legislature rejected his amendment and voted along party lines to restore the expansion plan to the spending package. On Aug. 10, Baker vetoed the measure.

Because lawmakers have recessed from formal legislative sessions for the year, they can't override Baker's veto — likely spelling the plan's demise.

In his veto letter, Baker noted that there are still a "significant number" of people who qualify for ConnectorCare but haven't signed up for coverage and said the state should promote increased enrollment rather than expanding coverage.

"The potential impact on carriers and enrollees, availability of enhanced federal funding and subsidies, and Connector systems changes needed to support such a program are all critical factors that need to be fully understood to minimize market disruption and ensure fiscal and operational viability," he wrote.

Amy Rosenthal, executive director of the health care consumer advocacy group Health Care For All, called Baker's decision "a significant step backward for health care coverage and access" in the state.

"At a time when families are struggling to make ends meet in the face of rising costs, denying them access to care and relief from health care costs does not make sense," she said.

The ConnectorCare Care program, which was created as part of the state's landmark 2006 health care law, offers low-premium plans with no deductible and limited cost-sharing to about 150,000 members.

Massachusetts law requires people to have health coverage, and the state boasts one of the highest insurance coverage rates in the nation. But advocates say studies have shown at least a quarter of residents have "unmet health care needs" due to high costs, and more than half face challenges affording care.

The ConnectorCare expansion pilot targeted middle-income individuals and households who make too much money to qualify for coverage from MassHealth, the state's Medicaid program, but are still struggling to afford the cost of private health plans.

Advocates said the expansion would offer lower premiums and deductibles, as well as other subsidies to families, which offer ConnectorCare coverage to another 37,000 individuals who currently don't qualify.

The pilot, which would cost up to $150 million over the two-year period, would be paid for with accrued savings from enhanced federal subsidies for health insurance provided during the pandemic.

But critics said the expansion would create a "cliff" when the two-year pilot project expires, forcing the state to either come up with funds to continue the subsidies or drop coverage for those who received it as part of the expansion.

Christian M. Wade covers the Massachusetts Statehouse for North of Boston Media Group's newspapers and websites. Email him at [email protected].