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Presentation to: Alliance for Health Reform Congressional Briefing Kaitlyn Kenney Director, Policy & Research Health

Presentation to: Alliance for Health Reform Congressional Briefing Kaitlyn Kenney Director, Policy & Research Health Connector May 24, 2010. Role of the Health Connector. The Massachusetts “Exchange” Established as part of MA Health Care Reform in 2006 Responsibilities:

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Presentation to: Alliance for Health Reform Congressional Briefing Kaitlyn Kenney Director, Policy & Research Health

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  1. Presentation to:Alliance for Health ReformCongressional BriefingKaitlyn KenneyDirector, Policy & ResearchHealth ConnectorMay 24, 2010

  2. Role of the Health Connector • The Massachusetts “Exchange” • Established as part of MA Health Care Reform in 2006 • Responsibilities: • Administration of two programs: • Commonwealth Care for subsidy-eligible adults (< 300% FPL) • Commonwealth Choice for unsubsidized non-group & small-group insurance • Young Adult Plans (YAPs) offered through this program • Policy development: • Affordability Schedule • Minimum Creditable Coverage (MCC) regulations

  3. Young Adult Plan Development • DOI and Health Connector developed regulations to define YAP benefits • Coverage includes: inpatient and outpatient hospital services, physician services for physical and mental illness, emergency services, and all MA mandated benefits • Offered both with and without prescription drug coverage • May include annual benefit max of no less than $50,000 • YAPs sold to individuals ages 18 – 26 solely through the Health Connector

  4. YAPs vs. Catastrophic Plan

  5. Commonwealth Choice: Shopping Experience

  6. Step 1: Select Family Size Step 3: Provide demographic info and select coverage start date Step 2: Determine whether eligible for subsidized plan Commonwealth Choice: Shopping Experience (con’t)

  7. Commonwealth Choice: Shopping Experience (con’t)

  8. Commonwealth Choice: Shopping Experience (con’t) Step 5: Select High or Low and With or Without prescription drug coverage

  9. YAP Enrollment • YAP subscribers represent about 25% of total non-group enrollment (~4,700 subscribers) • About 80% of those eligible for a YAP enroll in a YAP • About 67% of individuals choosing a YAP select a plan with prescription drug coverage • MA extended dependent coverage, but expansion under PPACA may impact YAP take-up

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