Open Enrollment in the Commonwealth: What You Need to Know

As sparkling lights spring up on houses, holiday music fills the stores, and a chill is in the air, it is clear it must be that time of year again. That’s right, there are less than two months left before the 2020 health insurance open coverage period is over! Here in the Commonwealth, open enrollment in the Massachusetts Health Connector lasts through January 23, 2020.  Any changes to coverage after this deadline must meet the qualifications for a Special Enrollment Period.

As many of you might remember, in 2006, Massachusetts implemented a significant health care reform initiative that expanded Medicaid eligibility, established a health insurance exchange, and reformed the insurance market to move towards a more affordable and accessible model. This allowed the Commonwealth to develop one of the most robust health care coverage systems which ultimately served as a model for the Affordable Care Act (ACA) (i.e., Obamacare). As a result, Massachusetts consistently has the lowest uninsured rate and the lowest average unsubsidized premiums nationally, with only 2.8 percent of the population remaining uninsured as of 2017.

One critical component of the 2006 reform was a statewide individual mandate requiring residents to obtain coverage if it is considered affordable, given life circumstances. To meet the individual mandate, residents must enroll in a health plan that meets minimum creditable coverage, which must cover many of the most common services that individuals and families need, such as doctor visits, hospital admissions, emergency services, behavioral health, prescription drugs, and more.

While the reform allows for short gaps in coverage without penalty, those who do not satisfy the mandate are subjected to a tax, ranging from $22-127 per month in 2019. Despite the elimination of the federal penalty for individuals without coverage, Massachusetts remains one of a handful of states where a mandate for coverage still exists.

Enrollment through the Massachusetts Health Connector has increased every year since 2014 and it does not appear to be slowing down. From 2018 to 2019, the number of people enrolled in qualified health programs rose from 267,260 to 301,879, a 13 percent increase. Notably, while some states have struggled to provide options for consumers, choices for residents of the Commonwealth remain robust, with more than nine insurers offering plans through the Massachusetts Health Connector in 2020.

For individuals and families who require more financial support, there is also the option of ConnectorCare plans. There are three different levels of plans depending on where the enrollee’s income falls compared to the poverty level and plans are offered for those whose income is up to 300 percent of the poverty level.

Make signing up for health insurance part of your holiday plans. There are a wealth of resources and people available to help you. More information about Massachusetts’s Health Insurance Exchange can be found on the Health Connector. For assistance navigating the system, get in touch with Health Care For All’s Massachusetts Consumer Assistance Program or the state-based resources available through the Office of Patient Protection.