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SENATE DOCKET, NO. 1381 FILED ON: 1/21/2011 SENATE . . . . . . . . . . . . . . No. 519
The Commonwealth of Massachusetts _________________ PRESENTED BY: Mark C. Montigny _______________ To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General The undersigned legislators and/or citizens respectfully petition for the passage of the accompanying: An Act relative to health care affordability. _______________ PETITION OF:
SENATE DOCKET, NO. 1381 FILED ON: 1/21/2011 SENATE . . . . . . . . . . . . . . No. 519
An Act relative to health care affordability. Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows: Section 1. Subsection (a) of section 2 of chapter 111M of the General Laws is hereby amended by inserting after the words “established by chapter 176Q” the following:- by regulation, in accordance with the requirements of subsection (d). Section 2. The first sentence of subsection (b) of said section 2 of said chapter 111M of the General Laws is hereby amended by striking out clauses (ii) and (iii) and inserting in place thereof the following clauses:- (ii) claims an exemption under section 3, (iii) had a certificate issued under section 3 of chapter 176Q, or (iv) had adjusted gross income as shown on the individual’s state tax return such that the amount required to purchase the lowest cost insurance on the market for which an individual would be eligible for creditable coverage, taking into consideration the out-of-pocket costs, as shown in the schedule created pursuant to subsection (p) of section 3 of chapter 176Q, exceeds the amount which an individual could be expected to contribute towards the purchase of insurance in the report published pursuant to subsection (q) of section 3 of chapter 176Q. Section 3. Said section 2 of chapter 111M of the General Laws, as so appearing, is hereby further amended by inserting after subsection (c) the following subsections:- (d) The affordability schedule set by the board of the connector pursuant to subsection (a) shall be subject to the following requirements: (1) in determining whether creditable coverage is affordable, the board of the connector shall consider expected enrollee expenditures as the 90th percentile of out-of-pocket costs plus premiums for those enrolled in creditable coverage; (2) For the purposes of this section, “out-of-pocket costs” shall mean the amount paid by an enrollee to satisfy the applicable annual deductible, co-payments and co-insurance, not including monthly premiums. |