The current rules of the individual mandate and Commonwealth Care eligibility have inadvertently created a pocket of people caught in a “Bermuda Triangle” of missed health care coverage. These people are employed, earn $29,412 or less (300 percent of the federal poverty level), and find themselves caught in the trap of being offered health insurance through their employer (thus becoming ineligible for Commonwealth Care), yet earning too little to be able to afford it. The Connector created the waiver process to exempt them from the individual mandate — good news for their wallets, as they can avoid penalties, yet they remain uninsured.
The question and challenge before us is, simply: How do we fix this coverage quandary? Consider the irony for a group of people doing the “right thing” — working full-time in low-paying jobs — unable to access affordable coverage, while others who may not be working can enjoy robust coverage at subsidized rates.
One possible solution is to allow employers to contribute to their employees’ Commonwealth Care premiums, using the dollars they would have spent if their employees had taken their health plan. The challenge is that, for many businesses, “savings” from employees who decline coverage are a necessity for their bottom lines. Yet without some employer contribution, including this additional group in Commonwealth Care will cost the state millions in public dollars.
Shouldn’t this group, stuck between no coverage and unaffordable coverage, be entitled to the lowest-price option for their health insurance? Let’s make sure they get it.Christina Severin is executive director of Network Health, a health plan with more than 125,000 low- and moderate-income members with state-subsidized health insurance across Massachusetts.
This program aired on August 7, 2007. The audio for this program is not available.