Learn the truth about the Chapter 58 Massachusetts insurance mandate law

False health reform hurts residents

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• What the Law Says - Insurance plan "lock-in" 

As quoted from the law: "Enrollees will have 60 days to change health plans for any reason. After the 60-day period has passed, you may only change your health plan for the following reasons: 

- you move and your new address is outside of your health plan's service area  
- you can demonstrate to the Connector that your health plan has not provided you with access to health-care providers that meet your health-care needs over time, even after you have asked the health plan for help  
- your primary care provider is no longer part of the health plan you enrolled in or there is a significant change in the health plan's group of providers  
- Commonwealth Care will also have an annual open enrollment period at which time you will have the chance to choose another health plan (provider) for any reason. During this period, you will receive information about all of your available health plan choices, and you can select a new health plan or stay enrolled in the one you chose when you first enrolled in Commonwealth Care." 

That is, if there is more than one provider in your area.

Keep in mind that if you are eligible for a $0 premium and there is more than one plan in your area, you will be obliged to pay 50% of the cost difference if you don’t choose the lower cost provider. Future policy changes will require that you pay 100% of the cost difference, and failure to pay a premium will result in a transfer to the lowest cost plan. This structure is meant to drive people into low premium plans because it costs the state less.

Having a doctor problem and need to change plans? These rules are yet another barrier to finding a doctor, having a choice and/or the ability to stay with the doctors who have been caring for you.

What this means

This means that once enrolled in an insurance policy, it must be kept for the entire year. 

Massachusetts-style health insurance 
is NOT what 
the doctor 
ordered!

Health Care is a right for all


If you lose your job-related plan through job change or unemployment, you will only be allowed 63 days to get another state-approved insurance policy. 

If you find that you can no longer afford your employer-offered insurance plan, you must buy a private plan on your own because a resident who declines employer insurance for any reason is not eligible for Commonwealth Care or Choice as long as the employer covers at least 20% of the annual premium for a family plan or at least 33% of the cost for an individual plan.

“Economists estimate that between 25 and 45 percent of the US labor force is now job-locked. That is, employees make career decisions based on their need to maintain affordable health coverage or avoid exclusion based on a preexisting condition.”  Boston Globe - August 11, 2007

How many families do you know who keep a job that is making them miserable just for the sake of the insurance? How many mothers or dads could be home with their kids if they didn’t have to do this? 

 

What the Law Says - The law requires "Portability" of insurance

This is a great idea because it means that you don't lose your insurance if you lose or change your job. 

What this means

This also means that if either of these things happen, you are still responsible for paying the full premium, even if you can't afford it. If you are unable to pay, you will be in violation of the law.

» Read the next "What the Law Says" topic
  » See the Law Topic Index 

The Individual Mandate explained  /  The Connector Authority  /  Affordability  /  The Appeals Process 

Religious Exemption  /  Income estimation  /  Tax enforcement and Criminal penalties  /  Data Gathering

Estate Recovery  /  Insurance plan "lock-in"  /  State as health insurance  /  Primary Care Shortage