How the Affordable Care Act Will Affect Massachusetts

state house photo via shutterstock

Enrollment for the Affordable Care Act (ACA) begins October 1st, and coverage starts January 1st. With just a week to go before enrollment, Governor Deval Patrick held a roundtable with local healthcare experts at the State House to discuss how the ACA benefits Massachusetts residents and how the new law will advance the Commonwealth’s health care reform goals.

Experts included Secretary of Administration and Finance, Glen Shor, Secretary of Health and Human Services, John Polanowicz, Executive Director of the Health Connector, Jean Yang, and MassHealth Acting Director Kristin Thorn. The meeting addressed how the implementation of the Affordable Care Act will affect Massachusetts residents, businesses, and insurers.

Here are 10 takeaways from the roundtable:

1. The ACA ensures affordable coverage for more middle income families. The ACA extends health subsidies to people whose incomes are 300 percent to 400 percent of the federal poverty level (that is approx. $46,000 for an individual). This measure is to try to make health insurance affordable for more low-and-middle-income families.

2. Provides billions in additional federal dollars for Massachusetts. According to the panel of experts, the ACA streamlines state health insurance programs while providing additional federal reimbursement for people already covered. The ACA will also provide grants to help states protect taxpayers from excessive premiums.

3. Provides tax credits to small businesses and increased coverage for employees. The ACA establishes tax credits for some small employers in order to make it more affordable to cover their employees. This can be combined with additional wellness rebates (things like gym memberships and diagnostic testing). Very low-income employees who cannot afford their employer’s coverage will become newly eligible for MassHealth, without any penalty for employers.

4. Covers preventive health services with no co-pay. Most health plans must now cover preventive services like shots, smoking cessation, and cancer screenings at no cost to the consumer. The panel said that this will help increase access to critical preventative care in the short term, and hopefully save lives in the long run.

5. Makes prescription drug coverage more affordable for seniors. The ACA closes what is called the “donut hole” in Medicare prescription drug coverage. According to the Patrick Administration, approx. 60,000 Mass. seniors saved an average of $667 each on prescription drugs in 2012, and will save even more once the hole is completely closed.

6. Rewards quality of care, rather than quantity. ACA supports the goals of the state’s 2012 cost containment law by promoting the formation of Accountable Care Organizations that reward the quality and efficiency of care rather than the quantity of care.

7. Reduces childhood obesity and tobacco use. Even though some parts of Mass. are doing well when it comes to programs to prevent childhood obesity, the Department of Public Health will use ACA grants to improve emergency medical services for children, reduce childhood obesity, and encourage tobacco cessation.

8. Strengthens the primary care system and supports community health centers. According to literature provided by the Patrick Administration, the ACA has already provided more than $130 million to community health centers in Mass. to strengthen their programs while expanding access to primary care for community members.

9. Expands coverage for young adults. Under the ACA, young adults are able to stay on their parents’ coverage until age 26.

10. Creates new protections to ensure your insurance plan covers you when you need it. The ACA will enhance these protections by eliminating limits on the amount of benefits you can receive.

Do you have additional questions? Tell us in the comments. We’ll be following up with Gov. Patrick’s office this week to address any new questions and concerns.