Obamacare Means Big Changes for Romneycare

By Joshua Archambault
December 7th, 2011

The Connector held its annual retreat this past weekend, and since the omnipresent Health Care for All (HCFA) representatives were not in attendance to write up a summary, I thought I would provide an overview of what was discussed at the meeting, and outline some of the future challenges for the Connector. The agenda can be found here.

The main theme of the retreat was the Affordable Care Act’s (ACA) impact on the Massachusetts reform. Connector staff, confirmed what Pioneer’s research has shown, that the Connector we know today will look very different by 2014. Here are a few of the examples of the policy discussions ahead:

• The Connector will need to figure out changes to the individual mandate (MEC in the federal law) vs our current minimum creditable coverage.
• Adjustments to the penalty and affordability schedules.
• Changes to employer responsibilities.
• Matching essential health benefits (EHB)– in the federal law vs. our mandated benefits.
• Changes to the seal of approval process, by which insurance plans are approved to be sold in the Connector.
• The return of an employee choice model. (Pioneer has written on the design failures and manipulation of the CP program by staff the first time around, hopefully the Connector can learn from past mistakes.)
• Big changes to the Young Adult Plans. The state may have to offer a catastrophic insurance plan for the first time, which a few Connector Board members are ideologically opposed to, but Governor Romney envisioned as the basic level of coverage in the 2006 law.
• There will be some shifting in the metallic tier levels within the exchange.
• The introduction of navigators into the Massachusetts market.
• The incorporation of risk adjustment mechanisms, risk corridors, and reinsurance programs.

While these provisions are not exhaustive, they do outline some major policy discussions ahead, and many have financial consequences for the state budget. I will cover some of the budget fall out in the next post.

This blog post is part 2 of 4 from the Connector meeting.

Twitter @josharchambault