MA Health Care Board Pondering Employer Payment Hikes

March 24, 2008 ( The board running Massachusetts' new state-subsidized health insurance program is considering raising contributions required from employers that fail to provide coverage to their workers.

Currently employers must pay up to $295 per uninsured employee per year. This fee has raised only about $6 million this year, far less than had been expected, according to Business Insurance.

In addition, individuals participating in Massachusetts’ new state-subsidized health insurance program will pay more for coverage because, starting July 1, the plan is projected to cost significantly more than the $869 million allotted for it in the state’s 2009 budget, the Business Insurance news report said.

The Commonwealth Care board of directors voted unanimously to raise premium contributions by 10%. The increase is less than the 15% insurers participating in the program had sought.

Under the program, premium contributions are required from plan members earning 150% of the federal poverty level or more. As a result of the decision, the lowest premiums will range from $39 to $116 per month, depending on income level.

The board also voted to raise copayments for doctor’s office visits by $5. For enrollees at the highest income levels covered in the program – individuals making between $26,000 and $31,000 annually – copayments for use of emergency room and outpatient surgery also will rise, the news report said. The board placed caps on out-of-pocket medical expenses for all medical care, excluding prescription drugs, of $750 or $1,500, depending on the individual’s income.

Part of the reason for the increased costs is the higher enrollment in the program, Business Insurance said. Currently, 176,000 of the state’s more than 372,000 uninsured residents have enrolled in the plan, which was created by 2006 health reform legislation.