FAQ's (this page was updated 10/21/11) * indicates updated area
1) What did they change the rules for buying private health insurance for individuals and who is fixing this issue? *
IN 2010 the insurance companies convinced the state legislature that people in the private insurance makret were "gaming the system" and causing the insurance companies to lose money. So the state legislature changed the law governinng when and under what circumstances individuals can buy insurance in the private market place. This new law did not change the rules for those in subsidized care, or how businesses can buy insurance. The law only changed it for those individuals who earn over 300 percent of the Federal Poverty Line. (For the record the Artists Health Care Working and Healthcare for Artists.org were against how this change was put into place and testified against it).
There is a strict open enrollment period and if individuals miss that period they will more than likely be locked out of buying insurance unless they have a "qualifying event". Note if your employer offers you insurance and it meets minimal credible coverage, you are not allowed to forgo you employer's insurance and buy insurance on the private market place- unless you have a qualifying event (so if you dont' like the insurance your employer is offering you is not sufficent to allow you to buy private insurance even if you can afford it). For more information see the Connector's PDF fact page. We also urge you to call Health Care for All's FREE Helpline for information and help: 1-800-272-4232. AND call your state representative and state senator and urge them to change this law!
2) What are the fines for 2011? How can I find out if insurance is affordable by the state's standards? What is a certificate of exemption from the mandate and how do I get one?
A message from the Connector (aka The State Agency-Commonwealth Health Insurance Connector Authority):
"The Connector is not interested in penalizing people, we're interested in insuring them. With that in mind, we understand the issues at hand regarding enrollment efforts and penalties for those still trying to get into a plan. We encourage all individuals to continue to apply, enroll in a plan, and pay their initial premiums as soon as possible. As things stand now, there is a robust appeals process that has been put in place that will take those situations into consideration, and other options are being discussed."
3) What if I have applied/submitted my paper work to see if I am eligible for Commonwealth Care or a MassHealth program and I have not heard back yet?
From what we understand you will not be penalized if you are in this situation. As soon as we know more we will post that info on this page. All applications for Commonwealth Care and MassHealth Programs are processed by MassHealth- a state agency. Note it can take up to 3 1/2 weeks for MassHealth to process applications. If you are having problems with MassHealth on your determination (i.e. they are not getting back to you, you don't understand their letters or what they are asking you for, etc.) please contact Health Care for All's Helpline: 1-800-272-4232
4) What happens if I don't abide by the mandate? Will I go to jail? What if I honestly can't afford any of the health insurance options?
If you don't abide by the mandate you will not go to jail, but you may be financially penalized by losing your personal exempting on your state taxes. The Department of Revenue is going to be enforcing the law and will be making determinations concerning fines. The exemptions and waivers will be done by the Connector Authority. There is now a waiver process for those who can't afford any of the health insurance options. We have key information on the individual mandate and the waiver process. IF YOU ARE UNINSURED, NOT EXEMPT FROM THE INDIVIDUAL MANDATE, we urge you to get insurance as soon as possible.
Please also note that there have been several pieces of legislation filed to help individuals obtain health insurance more easily. Please see our legislation page. Remember that the proposed legislation is not law and you must abide by the laws and regulations as they exist now.WE WILL NEED YOUR HELP to get these pieces of legislation passed. Join this site's list serve as the first step in helping to get these passed.
5) This is not universal health care. Why didn't they create a single payer system when they had the chance?
The short answer is that the political will is not quite there yet for a single payer system in this country. The HealthcareForArtists.org has always endorsed a single payer system for our population (artists).
The long answer is that the Federal Government mandated our state to change how the state administered free health care and the health care programs that received federal dollars. If our state did not do this, the state would lose its federal funding. The Feds were very clear they did not want a Medicaid or single payer system using federal dollars as the solution. This is our state's attempt to try to get people affordable health insurance with out losing the much needed federal funds. This law is clearly a work in progress. The very good news is that the policy makers, legislators, and state agencies are making every effort to make sure artists are not hurt by this law. The AF and all of the coalitions we are part of are actively taking part in that dialog.
You need to become active. If you are interested in working on this law and being part of this important dialog, you need to join the free list serve on this site and also send us an email letting us know you want to help out. If you want a single payer system you need to help to work towards it:Universal Health Care/Single Payer Resources:
• Single payer guide from the Massachusetts Nurse's Association
http://www.massnurses.org/single_payer/singlepay.htm• Mass-Care aka The Massachusetts Campaign for Single Payer Health Care
www.masscare.org6) Why aren't the insurance companies having to give back? They stand to make money on this Health Care Reform Law.
This is a good observation and yes they will make money if everyone has to have health insurance in this state. The health insurance companies, however, due to this law, are now under the spot light and are being closely examined. You will more than likely start to see more reform coming their way. We have counted three bills that we know of that have been filed to have reform in the insurance industry.
7) How are medical and health insurance costs going to be controlled?
It is true that health insurance plans premiums and health care costs continue to rise and soon many people and businesses will not be able to afford the premiums in the very near future. Many are struggling now to afford health insurance. There are several pieces of legislation filed and a state wide council appointed to do just this.
8) When did the change happen to the Massachusetts Independent Contractor Law? How is it going to impact me in work and in the Health Care Reform Law implementation? What is being done about it?
The law was changed in 2004 and most people in the Commonwealth are unaware of this change. Please read the section on this site for more information. What seems to be clear is that 2004 law will need to be repealed or amended to stop the negative impact it is and will have on the creative economy- specifically artists and small arts organizations. This law 2004 change, in combination with the health care reform law, has the potential to cause significant economic harm to artists, small arts organizations, and the private sector employment opportunities that artists depend on. The HealthcareForArtists.org is part of a statewide task force working on this issue.
9) My employer(s) don't seem to know anything about this new law and that they are suppose to be offering health insurance coverage to their employees. What is being done about this?
Many employers are not aware of the Health Care Reform Law and its requirements. This is not entirely their fault as the Connector Authority is just starting its information outreach campaign to businesses and individuals. The Connector has set up a public information unit and the phone number is 617-933-3140 or you can email connector@state.ma.us As soon as we have a contact person's name and direct phone number we will post it.
If you feel comfortable and know that you job will not be endanger, you could direct your employer(s) to this web site's section for employers and also to the FAQ's for Businesses of the Connector's web site. Also if you think your employer(s) might be eligible for the Insurance Partnership, you could direct them to the IP's web site or you could call the IP anonymously and direct the IP staff to call your employer(s).
10) What happens if I enrolled and got accepted into Commonwealth Care and my employer or one of my employers offers me insurance AFTER I have enrolled in Commonwealth Care?
If your employer or one of your employers offers you insurance AFTER you have enrolled in Commonwealth Care and your employer offers to pay 33 percent or more of your individual plan or 20 percent or more of your family plan, you will be de-enrolled (effectively kicked off) from Commonwealth Care. This is going to be the case even if you can not afford the premium from the health insurance plan offered to you by your employer. BUT the Connector is reconsidering this provision. The Connector is possibly considering that the employer could pay the State the same amount they would be paying an insurance company and the Connector would allow the employee to stay on the Commonwealth Care program. Again join this site's list serve to be kept up to date on this issue and others.
11) I have heard that there was a change in how the Connector Authority is determining income and that they are using adjusted gross income as the measure for the subsidized health plans. Is this true?
No that is not at all true. The Connector is not using adjusted gross income as the measure for the subsidized health care plans. There has been some misinformation in the press and on some websites in regard to the Adjusted Gross Income Change. This change is ONLY for the Individual Mandate NOT for how the state is determining if someone is eligible for the subsidized health care plans such as Commonwealth Care or a MassHealth Program.
The subsidized plans use annual gross income as the measure and to be eligible an individual's or a family's annual gross income must be at or below 300 percent of the Federal Poverty Level. Please be aware that the FPL amount changes on April 1st - they go up! 300 percent of the FPL for an individual is approximately $32,676 and to find what 300 percent FPL for a family is, add an additional $11,460 for each additional dependent to $32,676 (see the Insurance Partnership's web site for a better understanding of the FPL which is also referred to as income ceilings).
Annual gross income for those who are self-employed, seasonal workers, don't have regular pay stubs, and/or have combination income sources (W-2 income, 1099 income, etc.), is determined differently from those with just W-2 income wages with regular pay stubs. Those whose income is not solely from W-2 income sources with regular pay stubs, should contact an enrollment specialist in person to determine what their income is.(Contact Health Care for All's Help line or an enrollment specialist at a community health center, hospital, or at a health care advocacy organization).