Even so, seeking coverage expansions in a multipayer context (individual and employer-based coverage plus public programs) posed a set of policymaking challenges. Massachusetts had several advantages as it approached reform, including a relatively high percentage of the population that already had coverage, an uncompensated care pool that could be converted to dollars for coverage, and the ability of a Republican governor and Democratic legislature to work constructively together. This article describes the substance and the politics of the steps that were taken to achieve this level of coverage. Data show that only 2.6 percent of the state's population was uninsured in 2008 ( Long, Cook, and Stockley 2008). The experience of the 2006 health reform in Massachusetts suggests that in combination, these tools can be helpful. With a single-payer option off the table, as it was in the 2009 federal health reform debate, requirements, incentives, and regulations now are the tools available to reformers who seek universal health insurance coverage. Implementation entailed trade-offs between the comprehensiveness of benefits and premium costs, the subsidy levels and affordability, and among the level of mandate penalties, public support, and coverage gains.Ĭonclusions: National lessons from the Massachusetts experience come not only from the specific decisions made but also from the process of decision making, the need to keep stakeholders engaged, the relationship of decisions to existing programs and regulations, and the interactions among program components. Methods: The data in this article are based on a case study of Massachusetts, including interviews with key stakeholders, state government, and Commonwealth Health Insurance Connector Authority officials during the first three years of the program and a detailed analysis of primary and secondary documents.įindings: Coverage expansion and an individual mandate led Massachusetts to define affordability standards, establish a minimum level of insurance coverage, adopt insurance market reforms, and institute incentives and penalties to encourage coverage. While achieving political consensus on reform is difficult, implementation can be equally or even more challenging. This is because if there are any issues with a third-party service, the Health Connector cannot help resolve them, and payment would still be required.Context: Much can be learned from Massachusetts's experience implementing health insurance coverage expansions and an individual health insurance mandate. These methods are NOT the best way to pay and are discouraged. Prism or other personal banking bill payment sites.Bill Pay through your bank/credit union.When you use a non-preferred payment method, if there is an issue with a payment, you would need to resolve it with the bank or third-party site.Įxamples of nonpreferred third-party payment methods may include: In-person at a Health Connector Walk-in Center in Boston, Springfield, or Worcester.Payment by mail to the address included on your bill. Payments by phone by calling 1-877-MA-ENROLL.Online payment through the Health Connector’s member portal and guest payment system.The best way to pay your Health Connector bill is by using a payment method offered by the Health Connector. Third-party payment methods are discouraged as the Health Connector cannot help resolve any issues with these services if they arise.Examples of nonpreferred, third-party payment methods include Bill Pay through your bank/credit union Mint bills (acquired by Intuit) DOXO Prism or other personal banking bill payment sites and My CheckFree.The Health Connector offers four preferred payment methods above: online payments, phone payments, mail payments, and in-person at a Walk-in Center.
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