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Massachusetts Law About Health Insurance

The Massachusetts Mandated Health Insurance Law

St. 2006, c.58. An Act Providing Access to Affordable, Quality, Accountable Health Care. Added MGL c.111M and amended many other sections. Key provisions of the law include subsidized health insurance for residents earning less than 300% of the Federal Poverty Level, and low-cost insurance for all other residents who are not eligible for insurance through their employers.

Massachusetts Regulations

956 CMR: Commonwealth Health Insurance Connector Authority

Federal Law

Patient Protection and Affordable Care Act, PL 111-148 (HR 3590). The federal Health Care law is over 900 pages long. Changes include increased protection for those with pre-existing conditions, heightened penalties for certain employers who don't provide insurance, additional availability of insurance for children up to age 26, closure of the medicare "donut hole" for prescription drug coverage and more.

Thomas More Law Center v. Obama, 6th Circuit Court of Appeals, June 29, 2011. "[T]he minimum coverage provision [individual mandate] is a valid exercise of legislative power by Congress under the Commerce Clause."

Selected Case Law

Finch v. Commonwealth Health Insurance Connector Authority, 461 Mass. 232 (2012). Coverage for legal immigrants. "Section 31(a) [of St.2009, c.65] cannot pass strict scrutiny. The discrimination against legal immigrants that its limiting language embodies violates their rights to equal protection under the Massachusetts Constitution." New!

Web Sources on the Mass. and Federal Laws

7 Changes to Expect in Your Health Coverage This Year, Boston.com, January 2011. Explains the biggest changes to federal health insurance law effective this January. "The federal health law supersedes Massachusetts law, so any provisions that conflict with your current state health plan will likely mean adjustments in your coverage."

Commonwealth Connector. Despite the vague name, this is the state agency managing mandatory health insurance. The two basic programs are Commonwealth Care, for lower income residents, and Commonwealth Choice, which offers private sector alternatives for those who don't qualify for low-income insurance.

The 2006 Massachusetts Health Care Reform Law: Progress and Challenges After One Year of Implementation, Blue Cross/Blue Shield Foundation of MA, Mass. Medicaid Policy Institute, and Mass. Health Policy Reform, May 2007. Outlines progress made to date, including implementation, infrastructure, community outreach and more. Also projects future issues and challenges.

Consumer Guide to Health Care Coverage, Mass. Office of Consumer Affairs. Extensive resource details who has to have insurance, types of plans, costs, finding a provider and more.

Health Care Resources: Private Programs, Health Care for All. Site includes many resources on Mass. health care from various sources including group insurance, non-group, COBRA and more.

Health Care Resources: Public Programs, Health Care for All. Site includes many resources on Mass. health care for various groups including young adults, pregnant women, elders and more.

MA Health Care Reform Law of 2006, ACT. Great summary of the provisions of the new health insurance law.

The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act, Democratic Policy Committee. Includes summary and analysis of the federal law, including an explanation of immediate benefits, section-by-section analysis, and an implementation timeline.

Re-Forming Reform: What the Patient Protection and Affordable Care Act Means for Massachusetts, Robert W. Seifert and Andrew P. Cohen, Center for Health Law and Economics, University of Massachusetts Medical School, June 2010. Detailed report explains positive and negative efffects of the federal law on Massachusetts residents.

Tax Information on Health Care Reform, Mass. Dept. of Revenue. Includes information on the tax implications of health care reform, with forms and more, for individuals, employers and insurance carriers.

What the Health Care Law Means for Massachusetts, Boston Globe, March 22, 2010. Lists key provisions of the federal law and differences with Massachusetts law.

Your Guide to Managed Care in Massachusetts, Mass. Division of Health Care Finance and Policy (DHCFP) and the Mass. Office of Patient Protection (OPP), January 2007. 43-page guide "that will help you: Learn the differences between different types of health insurance and how those differences affect you, Choose a health plan that best meets your needs, File an appeal or complaint with your health plan if the need arises, and Find additional information on health plans.

Other Health Insurance Issues

St.2010, c.207, Insurance Coverage for Autism. Effective Jan. 2011. Mandates coverage for particular interventions.

St. 2002, c.49, An Act Providing Equitable Coverage of Services Under Health Plans. Requires most insurers to provide coverage for hormone replacement therapy and contraceptives.

Frequently Asked Questions About COBRA Continuation Health Coverage, US Dept. of Labor. Includes information on eligibility and more.

Print Sources

Health Insurance Reform, Lorman Education Services, 2007.