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poverty. One plan will have higher premiums and lower copayments, while a second choice will have lower premiums and higher copayments. Four managed care plans began offering
Commonwealth Care on November 1, 2006. Coverage for people above 100% of poverty up to 300% of poverty began on February 1, 2007. As of December 1, 2007, around 158,000 people had been enrolled in Commonwealth Care plans. Initial bids received by the Connector showed a likely cost for the minimum insurance plan of about $ 380 per month. The Connector rejected those bids, and asked insurers to propose less expensive plans. New bids were announced on March 3, 2007. The Governor announced that "the average uninsured Massachusetts resident will be able to purchase health insurance for $ 175 per month." But plan costs will vary greatly depending on the plan selected, age and geographic location, ranging from just over $ 100 per month for plans for young adults with high copayments and deductibles to nearly $ 900 per month for comprehensive plans for older adults with low deductibles and copayments. Copayments, deductibles and out-of-pocket contributions may vary among plans. The proposed minimum creditable coverage plan would have a deductible no higher than $ 2,000 per individual, $ 4,000 per family, and would limit out-of-pocket expenses to a $ 5,000 maximum for an individual and $ 7,500 for a family. Before the deductible applies, the proposed plan includes preventive office visits with higher copayments, but would not include emergency room visits if the person was not admitted.
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fiscal year 2011 versus approximately $ 1 billion in fiscal year 2006. Some of this doubling in cost was funded by temporary grants and waivers from the United States federal government. The Blue Cross funded research did not address the increased costs in premiums for employers and individuals or other market dynamics – such as increased providers' costs and increased co-pays/deductibles – necessary to meet minimum creditable coverage standards that were introduced in
Massachusetts by other parts of the 2006 legislature and its resulting regulations. Separate research on Premiums and Expenditures found that fully adjusted premiums per member per month (PPMPM) for Massachusetts residents covered by comprehensive private insurance policies (approximately two thirds of the state population) increased approximately 9% in both 2009 and 2010 for subscribers in the "merged market", 7% in the midsized group market, and 5.4% in the large group market. These premium increase do not reflect actual resident experience particularly in the merged market because Massachusetts regulations allow age and other rating factors (e.g., even if premiums were held flat for 55-year-olds living on Cape Cod in construction work from year to year, the 55-year-old in 2009 would pay 10% more in 2010 for the same policy, possibly with lesser benefits).
1449:, "Medical Bankruptcy in Massachusetts: Has Health Reform Made a Difference?", compared bankruptcy filers from 2007, before reforms were implemented, to those filing in the post-reform 2009 environment to see what role medical costs played. The study found that: 1) From 2007 to 2009, the total number of medical bankruptcies (defined as due to unpaid medical bills or to loss of income due to illness, with no distinction between those causes) in Massachusetts increased by more than one third, from 7,504 to 10,093; and 2) Illness and medical costs contributed to 59.3% of bankruptcies in 2007 and 52.9% in 2009. The researchers note that the financial crisis beginning in 2008 likely contributed to the increased number of bankruptcies, and Massachusetts' increase in medical bankruptcies over the 2007–2009 period was nevertheless below the national average rate of increase. Still, the researchers explain that health costs continued to go up over the period in question, and their overall findings are "incompatible with claims that health reform has cut medical bankruptcy filings significantly." A 2015 study found that the law had "modest effects" on costs of outpatient care for people who were already insured. According to a 2016 study in the
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lower group insurance rates. The process of merging the two markets also froze the market for such insurance for a short period in April–May 2010 as the current government tried to keep the leading non-profit insurers, which insure over 90% of the residents, in the state from raising premiums for small businesses and individuals. Eventually the state's non-partisan insurance board ruled that the government did not have the actuarial data or right to freeze the premiums. Five of the non-profit insurers then settled for slightly lower premium increases than they had initially requested rather than litigate further. The sixth litigated and won the right to implement all its original increases retroactively. Payment rates were supposed to be increased to hospitals and physicians under the statute but that has not happened. The statute also formed a
1162:(EMTALA) in 1986. EMTALA requires hospitals and ambulance services to provide care to anyone needing emergency treatment regardless of citizenship, legal status or ability to pay. EMTALA applies to virtually all hospitals in the U.S. but includes no provisions for reimbursement. EMTALA is therefore considered an "unfunded safety net program" for patients seeking care at the nation's emergency rooms. As a result of the 1986 EMTALA legislation, hospitals across the country faced unpaid bills and mounting expenses to care for the uninsured. Some of these uncompensated care costs are paid by the federal government through Medicare and Medicaid Disproportionate Share Hospital (DSH) funding, though such payments are scheduled to decrease to achieve savings to offset the costs of the Affordable Care Act.
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approximately 400,000 residents added to the rolls of the insured in 2006/2007 via an expansion in
Medicaid eligibility rules and the subsidization of the Commonwealth Care insurance program. A 2011 view of the data, released by the state in 2013, shows the number of people receiving employer-sponsored insurance (ESI) in Massachusetts decreased by approximately 500,000 people (about 8% of the state population) since the enactment of the Massachusetts health insurance law in 2006. The latest U.S. Census data on health care insurance types in Massachusetts was released in September 2012, and also illustrates the long-term decrease in ESI, and an increase in public, free and subsidized insurance.
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those who do not have health insurance. According to the DHCFP in a report dated
September 2011, "Total Health Safety Net (HSN) payments increased by 7% in the first six months of Health Safety Net fiscal year 2011 (HSN11) compared to the same period in the prior year while demand increased by 10%. Demand represents the amount that providers would have been paid in the absence of a funding shortfall. Because HSN11 demand is expected to exceed HSN11 funding, hospital providers experienced a $ 38 million shortfall during the first six months of HSN11." Versus the same period two years earlier, HSN spending plus demand has increased 20%
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under the
Massachusetts law, residents buying healthcare insurance individually could do so at any time, even—theoretically—as being admitted to a hospital or entering an emergency room. This led to a gaming of the system and research by the state said this gaming added 1–2% to premium costs, which were continuing to rise for other reasons as well. Given the continuing overall rise in premiums post Massachusetts 2006 healthcare insurance reform, the major goal of the 2012 amendment was to introduce price controls on health care itself; it is not directly related to healthcare insurance as are the earlier legislative actions.
1225:. At the end of the month, the Joint Committee on Health Care Financing approved a reform proposal crafted by House Speaker DiMasi, Committee co-chair Patricia Walrath, and other House members. The state faced pressure from the federal government to make changes to the federal waiver that allows the state to operate an expanded Medicaid program. Under the existing waiver, the state was receiving $ 385 million in federal funds to reimburse hospitals for services provided to the uninsured. The free care pool had to be restructured so that individuals, rather than institutions, received the funding. U.S. Senator
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this study does not support those expectations." Other analysis concluded that preventable ED visits were reduced 5-8% for non-urgent or primary care ED visits relative to other states. A more complete report released in
January 2012 found between 2006 and 2010 emergency department visits and non-urgent visits had dropped 1.9 and 3.8% respectively. A 2014 study found that the law was associated with "a small but consistent increase" in ED use in the state. A 2014 study found that the reform was associated with "significant reductions in all-cause mortality and deaths from causes amenable to health care."
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resident demonstrates that there is no available coverage that is defined by the
Connector as affordable. In March 2007, the Connector adopted an affordability schedule that allows residents to seek a waiver. If a resident does not have coverage and does not have a waiver, the Department of Revenue will enforce the insurance requirement by imposing a penalty. In 2007, the penalty was the loss of the personal exemption. Beginning in 2008, the penalty is half the cost of the lowest available yearly premium which will be enforced as an assessed addition to the individual's income tax.
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and Policy issued regulations defining "fair and reasonable" for the fair share assessment. The regulations provide that companies with 11 or more full-time equivalent employees will meet the "fair and reasonable" test if at least 25 percent of those employees are enrolled in that firm's health plan and the company is making a contribution toward it. A business that fails that test may still be deemed to offer a "fair and reasonable" contribution if the company offers to pay at least 33 percent of an individual's health insurance premium.
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1381:. Among other differences, consistent with PPACA, the out of pocket spending limits and deductibles are higher under similarly priced (after a PPACA tax credit) PPACA-consistent insurance than the superseded Massachusetts insurance law. To try to compensate for these higher limits and deductibles, the Commonwealth funded an additional insurance program called Connectorcare, by which residents who previously would have qualified for Commonwealth Care can get very similar benefits for about the same price.
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Medicaid. The number of available plans under the
Affordable Care Act that will offer service beginning on January 1, 2014, rose to more than 100 from just under 100 in 2013. The open enrollment period of the insurance marketplace, during which citizens may re-enroll or purchase, lasted from 1 October 2013 to 31 March 2014, but those who did not re-enroll by December 15, were to have no insurance coverage in January 2014 (unless they were among the 100,000 moved to Medicaid).
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health care insurance. In addition the state spent a substantial amount of general revenue on the insurance reform. Based on the combination of the increased Health Safety Net tax, general revenue (state income and sales taxes were increased 20%) and smaller additional taxes, the cost of the reform reached about 2% of the state's annual budget in fiscal year 2013, which ended June 30, 2013, up from 1.5% in fiscal 2011.
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enrolled in the firm's health plan. Alternatively, a company meets the standard if it offers to pay at least 33% of the premium cost of an individual health plan. For employers with 50 or more FTEs, both standards must be met, or 75% of full-time workers must be enrolled in the firm's health plan. Regulatory and analytic information is available on the
Division's website.
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seniors the 2010 coverage rate was even higher, at 99.8 percent and 99.6 percent respectively. The breakdown of insurance coverage consisted of that 65.1 percent of state residents being covered by employers, 16.4 percent by
Medicare, and 16.6 percent via public plans such as Commonwealth Care. The state's Secretary of Health and Human Services,
1612:. The Appeals Court then heard the appeal and declined to send the case back to Essex Superior Court for trial by jury based on their belief that no facts needed to be determined and therefore trial by jury in this case was not a protected right under either the US or Massachusetts Constitutions. The SJC declined to hear any further appeals.
1455:, the reform "reduced the amount of debt that was past due, improved credit scores, reduced personal bankruptcies and reduced third-party collections." The authors note that the "results show that health care reform has implications that extend well beyond the health of those who gain insurance coverage."
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According to the DHCFP, 89,000 people bought healthcare insurance directly as of June 2009, up from 40,000 in June 2006. The number of people with group insurance in Massachusetts held steady at around 4,400,000 since passage of the health care reform law, according to the DHCFP. One outcome has been
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The Division of Health Care Finance and Policy defined by regulation what contribution level meets the "fair and reasonable" test in the statute. The regulation imposes two tests. First, employers are deemed to have offered "fair and reasonable" coverage if at least 25% of their full-time workers are
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programs. The most controversial change was the addition of a provision which requires firms with 11 or more workers that do not provide "fair and reasonable" health coverage to their workers to pay an annual penalty. This contribution, initially $ 295 annually per worker, is intended to equalize the
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In 2008 and 2010, much more substantive changes were made to the law, one of the most important of which was to begin an open enrollment period for those receiving subsidized health insurance and anyone buying insurance, including those paying full price, as an individual. Prior to that 2010 change,
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In Massachusetts, a pool of over $ 1 billion in 2004/2005, funded by a tax on paying hospital customers and insurance premiums, known as the Uncompensated Care Pool (or "free care pool"), was used to partially reimburse hospitals and health centers for these ED expenses. A much larger portion of the
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Reforms made in 1997 to the portion of the insurance market that related to the individual purchase of insurance had failed. In 2000, over 100,000 Massachusetts residents (about 1.5% of the population) were covered by individually purchased insurance but the number had dropped to under 50,000 by the
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and released in December 2010 by the Massachusetts Division of Health Care Finance and Policy stated that as of June 2010, 98.1 percent of state residents had coverage. This compared to 97.3 percent having coverage in the state in 2009 and 83.3 percent having coverage nationwide. Among children and
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The statute expanded MassHealth (Medicaid and SCHIP) coverage for children of low income parents and restores MassHealth benefits like dental care and eyeglasses. The legislation included a merger of the individual (non-group) insurance market into the small group market to allow individuals to get
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programs and required employers to either provide coverage or pay an assessment to the state. The coalition began gathering signatures to place their proposal on the ballot in November 2006 if the legislature did not enact comprehensive health care reform, resulting in the collection of over 75,000
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As illustrated in the state report referenced in the previous sentence, the price of insurance that covered about 600,000 people in the small group market (about 10% of the population) was rising faster than the prices for the vast majority of the non-senior-citizen population, most of which were –
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Data following enactment of mandatory insurance showed total emergency visits and spending continued to increase, and low-severity emergency visits decreased less than 2%; researchers concluded, "To the extent that policymakers expected a substantial decrease in overall and low-severity ED visits,
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Comparing the first half of 2007 to the first half of 2009, spending from the state's Health Safety Net Fund dropped 38–40% as more people became insured, before increasing in later years. The Fund—which replaced the Uncompensated Care Pool or Free Care—pays for medically necessary health care for
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approved the state's waiver application on July 26, 2006, allowing the state to begin enrolling 10,500 people from the waitlist for the MassHealth Essential program, which provides Medicaid coverage to long-term unemployed adults below the poverty line. In 2006, the Division of Health Care Finance
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Chapter 58 had several key provisions: the creation of the Health Connector; the establishment of the subsidized Commonwealth Care Health Insurance Program; the employer Fair Share Contribution and Free Rider Surcharge; and a requirement that each individual must show evidence of coverage on their
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At the point of the implementation of PPACA in 2014, of those citizens acquiring insurance through pre-ACA Massachusetts Health Connector plans, approximately 100,000 Massachusetts residents who received free or highly subsidized CommonWealth Care insurance, were expected be needed to be moved to
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In 2012, the Blue Cross Foundation of Massachusetts funded and released research that showed that the 2006 law and its subsequent amendments – simply in terms of measuring the state-budget effect on the uncompensated care pool and funding subsidized insurance had cost approximately $ 2 billion in
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Employers with more than ten full-time equivalent employees (FTEs) must provide a "fair and reasonable contribution" to the premium of health insurance for employees. Employers who do not will be assessed an annual fair share contribution that will not exceed $ 295 per employee per year. The fair
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The taxes that fed the state's "free care pool", which covered uninsured emergency room visits as well as uninsured hospital admissions (as well as funding community health centers), consistently underfunded the pool and had to be raised almost annually (with differences made up by appropriations
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During the years before the changes in the state law related to the enactment of the federal PPACA, the state still used the free care pool—renamed the Health Safety Net—both as originally intended and to fund the subsidies for free (under 150% of FPL) and almost free (151–300% of FPL) networked
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In the early years of the implementation of the law, approximately 2% of those eligible were determined not to have had access to affordable insurance, and a small number opted for a religious exemption to the mandate. Approximately 1% of taxpayers were determined by the Commonwealth to have had
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for the state subsidized Commonwealth Care plans. Premiums will vary from $ 18 per month, for individuals with incomes 100–150% of the poverty line, to $ 106 per month for individuals with incomes 250–300% of poverty. The Connector approved two copayment schemes for plans for people 200–300% of
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Residents of Massachusetts must have health insurance coverage under Chapter 58. Residents must indicate on their tax forms if they had insurance on December 31 of that tax year, had a waiver for religious reasons, or had a waiver from the Connector. The Connector waiver can be obtained if the
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Large employers—even large employers that were self-insured—were increasingly dropping health insurance as an employee benefit and/or restricting it to full-time employees such that the "take up rate" of healthcare insurance by employees was dropping. However, the drop in take-up rate actually
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The law mandated that nearly every resident of Massachusetts obtain a minimum level of insurance coverage, provided free and subsidized health care insurance for residents earning less than 150% and 300%, respectively, of the federal poverty level (FPL) and mandated employers with more than 10
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reported that Commonwealth Care faced a short-term funding gap of $ 100 million and the need to obtain a new three-year funding commitment from the federal government of $ 1.5 billion. By June 2011, enrollment was projected to grow to 342,000 people at an annual expense of $ 1.35 billion. The
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reported that more than a thousand people in Massachusetts had "gamed" the mandate/penalty provision of the law since implementation by choosing to be insured only a few months a year, typically when in need of a specific medical procedure. On the average, the Globe reported, these part-time
1418:
The number of uninsured Massachusetts residents dropped from about 6% in 2006 to about 2% in 2010, before increasing to between 3–4% in 2012. The United States Census Department shows a higher percentage of uninsured for the same years but a similar trend line. Both trend lines mirror the
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There was an additional Free Rider Surcharge assessible to the employer. This surcharge is different from the fair share contribution. The surcharge is applied when an employer does not arrange for a pre-tax payroll deduction system for health insurance (a Section 125 plan, or a
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pool was used for non-ED hospital care for the uninsured and for other care at Community Health Centers. It was predicted that implementation of the 2006 Massachusetts healthcare insurance reform law would result in almost complete elimination of the need for this fund. In 2006,
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There was a widespread feeling that emergency rooms were misused for non-emergency medical care (the misuse was and is undeniable, not unique to Massachusetts, and continues; the relation to healthcare insurance or lack of it was less clear and apparently did/does not
1477:, said, "Massachusetts' achievements in health care reform have been nothing short of extraordinary. With employers, government and individuals all sharing the responsibility of reform, we continue to have the highest insurance rate in the nation." In June 2011, a
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To handle this problem, a special temporary Medicaid was set up, and given to over 320,000 people at no immediate cost to them, who would have under normal ACA procedures gotten either a traditional Medicaid, an ACA expanded Medicaid, or an ACA on-exchange plan.
1249:, the House and Senate each passed health care insurance reform bills. The legislature made a number of changes to Governor Romney's original proposal, including expanding MassHealth (Medicaid and SCHIP) coverage to low-income children and restoring funding for
1221:, speaking at a Blue Cross Blue Shield Foundation Roadmap To Coverage forum in October 2005, pledged to pass a bill through the House by the end of the session. At the forum, the Foundation issued a series of reports on reform options, all of which included an
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expansion (administered by MassHealth) and half via the Connector's free and subsidized network-tiered health care insurance for those not eligible for expanded Medicaid. Relatively few Massachusetts residents used the Connector to buy full-priced insurance.
1530:, in 2019 the state's uninsured rate was about 3%, which at the time was the lowest in the country. Though 22% still have trouble paying their medical bills, "with many complaining that high-deductible health plans come with steep out-of-pocket costs."
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The six prompt overrides were noted at the foot of the chapter: Approved (in part) April 12, 2006. Disapproved sections 5, 27, 29, 47, 112, 113, 134 and 137. Sections 5, 29, 47, 113, 134 and 137, overridden on May 4, 2006; see chapter 58 text for
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problem although subsequent to the passage of the law, it is argued that the free-rider problem did not really exist. Almost all people who did not have insurance could not afford it, but since they were still using the good it is considered free
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The movement to reform Massachusetts healthcare insurance regulations and market between 2004 and 2006 was driven by multiple issues, not all of which were clearly an issue or directly related to then and now most critical issues of rising costs:
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The reduced state Health Safety Net payments anticipated (but not realized) that by reducing the number of uninsured people, Commonwealth Care would reduce the amount of charity care provided by hospitals. In a subsequent story that same month,
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A six-year-old federal-government waiver as to how Massachusetts administered its Medicaid program was expiring. Unless the waiver was extended or amended, a large number of people would lose Medicaid coverage as the state reverted to Federal
1628:, expected to begin operation in December 2017. This expanded the similar One Care prevention-oriented program for Massachusetts patients who were enrolled in both Medicare and Medicaid, or had disabilities or very low income.
1053:. The Connector acts as an insurance broker to offer free, highly subsidized and full-price private insurance plans to residents, including through its web site. As such it is one of the models of the Affordable Care Act's
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who have a U.S. sponsor who is financially responsible for them. The legislature promptly overrode six of the eight gubernatorial section vetoes, on May 4, 2006, and by mid-June 2006 had overridden the remaining two.
1604:(SJC), ordering Essex Superior Court to vacate this dismissal on procedural grounds, the failure to provide trial by jury in a dispute over property as requested by the plaintiff, was denied by Associate Justice
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official, as executive director of the Connector. On July 1, MassHealth began covering dental care and other benefits, and began enrolling children between 200% and 300% of the poverty level. The federal
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On April 12, 2006, Governor Romney signed the health legislation. He vetoed eight sections of the health care legislation, including the controversial employer assessment. He vetoed provisions providing
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After implementation of the law, 98% of Massachusetts residents had health coverage. Despite the hopes of legislators, the program did not decrease total spending on healthcare or utilization of
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926:
2220:
768:
4016:
389:
2189:
3593:, Massachusetts Law Reform Institute (MLRI) and Massachusetts Continuing Legal Education, Inc. (MCLE), Massachusetts Legal Services, 2009 edition, updated again in 2010 (3/18/2010)
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Advocacy groups wanted a long list of non-traditionally covered (e.g., vision care) or under-covered (e.g., mood-altering pharmaceuticals) healthcare procedures and goods mandated.
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waiver that would redirect money that previously went to treat uninsured patients at safety net hospitals to near-universal health insurance coverage as proposed by Travaglini.
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are employed by a small business (less than 50 employees) that uses the Health Connector to offer health insurance. These residents will purchase insurance with pre-tax income.
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Starting in 2014, Commonwealth Care insurance (and Commonwealth Choice insurance for those not receiving subsidies) has been replaced by insurance compatible with the federal
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At the start of the Affordable Care act open enrollment at the end of 2013, there was a major technical failure, and the MA Health Connector Software did not work at all.
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Report from Massachusetts Secretary of Health and Human Services, Timothy Murphy, to the Massachusetts General Court, "Chapter 58 Implementation Update" (June 12, 2006).
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It administers the ConnectorCare program for low-income residents (up to 300% of the FPL) who do not qualify for MassHealth and who meet certain eligibility guidelines.
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In November 2004, political leaders began advocating major reforms of the Massachusetts health care insurance system to expand coverage. First, the Senate President
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1608:. An appeal was then filed with the Massachusetts Appeals Court. A later petition for a writ of mandamus with the SJC was also denied, this time by Chief Justice
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The implementation of healthcare insurance reform began in June 2006, with the appointment of members of the Connector board and the naming of Jon Kingsdale, a
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predicted that the amount of money in the "free care pool" would be sufficient to pay for reform legislation without requiring additional funding or taxes.
2531:"Analysis of Individual Health Coverage In Massachusetts Before and After the July 1, 2007 Merger of the Small Group and Nongroup Health Insurance Markets"
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enrollees were paying $ 1,200–$ 1,600 in premiums over a few months and receiving $ 10,000 or more in healthcare services before again dropping coverage.
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1057:. The 2006 Massachusetts law successfully covered approximately two-thirds of the state's then-uninsured residents, half via federal-government-paid-for
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review concluded that the healthcare overhaul "has, after five years, worked as well as or better than expected." A study by the fiscally conservative
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Among its many effects, the law established an independent public authority, the Commonwealth Health Insurance Connector Authority, also known as the
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The enacted statute, Chapter 58 of the Acts of 2006, established a system to require individuals, with a few exceptions, to obtain health insurance.
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Beginning July 2007, the Connector offered reduced benefit plans for young adults up to age 26 who do not have access to employer-based coverage.
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894:
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477:
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550:
280:
57:
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1348:"), and has employees who receive care that is paid from the uncompensated care pool, renamed in October 2007 as the Health Safety Net.
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accelerated after passage of the law although there is no demonstrable relationship between the law's passage and the accelerated drop.
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and still are – covered by self-insured group insurance from large employers (self-insured plans are not subject to state regulation).
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was repealed in 2013 in favor of the federal mandate (even though enforcement of the federal mandate was delayed until January 2015).
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share contribution will be paid into the Commonwealth Care Trust Fund to fund Commonwealth Care and other health reform programs.
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Please help improve this article by looking for better, more reliable sources. Unreliable citations may be challenged and removed.
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3203:"Massachusetts Health Reforms: Uninsurance Remains Low, Self-Reported Health Status Improves As State Prepares To Tackle Costs"
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imposed for a citizen's failure to get health insurance as well as the fine imposed for a failure to provide information on a
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The Health Connector is designed as a clearinghouse for insurance plans and payments. It performed the following functions:
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1101:. In October 2006, January 2007, and November 2007, bills were enacted that amended and made technical corrections to the
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The MA Health Connector was functional starting at open enrollment for 2015, though problems were still widely reported.
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original projections were for the program to ultimately cover approximately 215,000 people at a cost of $ 725 million.
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1229:, a longtime advocate for universal healthcare, and Romney met with outgoing U.S. Health and Human Services Secretary
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as to whether that citizen had health insurance. The judge dismissed the case upon a motion filed by an assistant to
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3567:. Boston: Commonwealth of Massachusetts, Division of Health Care Finance and Policy (DHCFP). 2004. Archived from
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3342:"Temporary Medicaid coverage after Massachusetts Health Exchange website failed cost $ 650 million, state says"
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2902:"The Impact of Massachusetts Health Care Reform on Access, Quality, and Costs of Care for the Already-Insured"
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In 2022, the following carriers offer plans through the Massachusetts Health Connector insurance marketplace:
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was of the view that the reform was "responsible for a dramatic increase in health care spending," however.
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issues. The law was amended significantly in 2008 and twice in 2010 to make it consistent with the federal
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income tax return or face a tax penalty, unless coverage was deemed unaffordable by the Health Connector.
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1077:(ACA). Major revisions related to health care industry price controls were passed in August 2012, and the
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3157:"The Effect of Insurance on Emergency Room Visits: An Analysis of the 2006 Massachusetts Health Reform)"
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2336:"Chapter 58 of the Acts of 2006, An Act Providing Access to Affordable, Quality Accountable Health Care"
2281:"Chapter 58 of the Acts of 2006, An Act Providing Access to Affordable, Quality Accountable Health Care"
1740:"Chapter 58 of the Acts of 2006, An Act Providing Access to Affordable, Quality Accountable Health Care"
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Allegedly because of their lack of health insurance, uninsured Massachusetts residents commonly utilize
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2012:
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The new plan covered abortions (both elective and medically necessary) in the heavily Catholic state.
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In November 2016, MassHealth received a federal Medicare waiver that allowed it to transition from
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from general revenue). The combination of issues four and five was dubbed by Romney and others the
1074:
1423:
access to affordable insurance during tax year 2009 and had to pay an income tax penalty instead.
3322:
3118:
2378:
1222:
678:
560:
1962:
1871:
1233:
on January 14, 2005, Thompson's last day in office. The meeting resulted in Thompson signing a
3927:
3921:
3827:
3392:
3314:
3272:
3224:
2975:
2931:
2170:
2160:
1840:
1390:
1320:
1214:
sponsored a study, "Roadmap to Coverage," to expand coverage to everyone in the Commonwealth.
1183:
384:
3072:
BHI Study: Massachusetts Health Care Reform drives up insurance costs both public and private
1826:
3903:
3621:
3588:
3528:
3423:
3306:
3262:
3214:
3058:
2965:
2921:
2913:
2069:
1915:
1609:
1605:
1460:
1440:
the unavailability of coverage by many insurers previously doing business in Massachusetts.
1259:
1218:
1262:
benefits to poor residents on the Medicaid program, and providing health coverage to legal
3187:
3054:
1621:
1469:
1147:
2900:
Joynt, Karen E.; Chan, David C.; Zheng, Jie; Orav, E. John; Jha, Ashish K. (April 2015).
1987:
3445:
3090:"Massachusetts Health Reform Spending, 2006–2011: An Update on the "Budget Buster" Myth"
2384:. Boston: Massachusetts General Court, Committee on Health Care Financing. April 4, 2006
2335:
2280:
1810:"Impact of Merging the Massachusetts Non-Group and Small Group Health Insurance Markets"
1763:
1751:
1739:
1186:
called for a plan to reduce the number of uninsured by half. A few days later, Governor
3939:
3915:
3478:. Boston: Supreme Judicial Court and Appeals Court of the Commonwealth of Massachusetts
3419:"How Massachusetts became a national leader on health care — and how it can lead again"
2926:
2901:
1589:
1578:
1570:
1345:
1230:
739:
721:
3267:
3250:
974:
3985:
3933:
3909:
3883:
3251:"Increased Use of the Emergency Department After Health Care Reform in Massachusetts"
3249:
Smulowitz, Peter B.; O'Malley, James; Yang, Xiaowen; Landon, Bruce E. (August 2014).
2152:
1474:
1250:
1039:
663:
361:
3326:
2854:"Subsidized care plan's cost to double: Enrollment is outstripping state's estimate"
1775:
3832:
3472:"GEORGE FOUNTAS vs. COMMISSIONER OF THE MASS. DEPARTMENT OF REVENUE (SJ-2009-0146)"
1916:"American College of Emergency Physicians Survey of Emergency Department Directors"
1593:
1479:
1254:
free care pool charges imposed on employers who do and do not cover their workers.
1151:
1070:
726:
567:
156:
1105:(Chapters 324 and 450 of the Acts of 2006, and chapter 205 of the Acts of 2007).
3897:
3764:
3663:
2954:"The Effects of the Massachusetts Health Reform on Household Financial Distress"
1226:
1187:
1031:
801:
687:
1776:"Chapter 205 of the Acts of 2007, An Act Further Regulating Health Care Access"
1764:"Chapter 450 of the Acts of 2006, An Act Further Regulating Health Care Access"
3891:
3871:
3219:
2174:
1131:
960:
275:
2979:
2157:
The Ten Year War: Obamacare and the Unfinished Crusade for Universal Coverage
1190:
announced that he would propose a plan to cover virtually all the uninsured.
3119:"Impact of Massachusetts health law on emergency department visits examined"
2917:
1403:
1263:
1194:
3318:
3276:
3228:
2935:
2879:"Medical Bankruptcy in Massachusetts: Has Health Reform Made a Difference?"
2085:"Research on providing health coverage for the uninsured in Massachusetts"
1938:"How To Access Health Care – Massachusetts Uncompensated (Free) Care Pool"
1937:
1689:
17:
3290:
Sommers, Benjamin D.; Long, Sharon K.; Baicker, Katherine (May 6, 2014).
2970:
2953:
1724:
1597:
1198:
1058:
683:
454:
1752:"Chapter 324 of the Acts of 2006, An Act Relative to Health Care Access"
1206:
1102:
1099:
An Act Providing Access to Affordable, Quality, Accountable Health Care
472:
3625:
2133:. Worcester, Massachusetts: University of Massachusetts Medical School
3310:
1555:
Tufts (two separate entities: Tufts HMO and Tufts Health Public Plan)
1314:
are self-employed, part-time workers, or work for multiple employers,
1217:
Attention focused on the House when then-Massachusetts House Speaker
412:
3610:
3603:
3499:"GEORGE FOUNTAS vs. COMMISSIONER OF THE MASS. DEPARTMENT OF REVENUE"
2084:
1402:
Also effective in 2006, the Connector Board set premium levels and
1302:
It offers for purchase health insurance plans for individuals who:
2311:"Mitt Romney health care vetoes overturned by Massachusetts House"
1326:
It defines "affordability" for purposes of the individual mandate.
1202:
667:
639:
Health Information Technology for Economic and Clinical Health Act
3636:
3201:
Long, Sharon K; Karen Stockley; Heather Dahlen (January 2012).
1287:
to issue quality standards and publicize provider performance.
3632:
2548:"Premium Levels and Trends in Private Health Plans: 2007–2009"
1167:
627:
Medicare Prescription Drug, Improvement, and Modernization Act
247:
186:
125:
72:
31:
3292:"Changes in Mortality After Massachusetts Health Care Reform"
3800:
3367:"Health disconnector: Customers angered by coverage hurdles"
1988:"Medicaid Disproportionate Share Hospital (DSH) Reductions"
1537:
AllWays Health Partners (formerly Neighborhood Health Plan)
2597:. Boston: Commonwealth of Massachusetts. September 8, 2006
1705:"Mass. health care reform law's employer mandate repealed"
3565:
The Official Website of the Commonwealth of Massachusetts
2720:
The Official Website of the Commonwealth of Massachusetts
2595:
The Official Website of the Commonwealth of Massachusetts
2569:
The Official Website of the Commonwealth of Massachusetts
2340:
The Official Website of the Commonwealth of Massachusetts
2285:
The Official Website of the Commonwealth of Massachusetts
2017:
The Official Website of the Commonwealth of Massachusetts
1780:
The Official Website of the Commonwealth of Massachusetts
1768:
The Official Website of the Commonwealth of Massachusetts
1756:
The Official Website of the Commonwealth of Massachusetts
1744:
The Official Website of the Commonwealth of Massachusetts
1732:
The Official Website of the Commonwealth of Massachusetts
2828:"Healthcare cost increases dominate Mass. budget debate"
1855:"Annual Report on the Massachusetts Health Care Market"
390:
Secretary of Health and Human Services of Massachusetts
211:
2571:. Boston: Commonwealth of Massachusetts. July 28, 2006
2517:"Open enrollment set in Massachusetts for health care"
2361:
2359:
2357:
1719:
The General Court of The Commonwealth of Massachusetts
1038:
to nearly all of the residents of the Commonwealth of
3866:
Turnaround: Crisis, Leadership, and the Olympic Games
3524:"Massive change coming to state health care for poor"
2947:
2945:
3613:
Massachusetts Medicaid Consultations - official site
2952:
Mazumder, Bhashkar; Miller, Sarah (August 1, 2016).
2639:"Press release on minimum creditable coverage plans"
3882:
3857:
3841:
3818:
3694:
3543:
Mass. health program searches for the hard-to-reach
3393:"Health Insurance Coverage of the Total Population"
2462:"Massachusetts's Health Care Reform Law Fact Sheet"
2065:"My plan for Massachusetts health insurance reform"
1616:
Transition from fee-for-service to accountable care
1089:The healthcare insurance reform law was enacted as
1030:law passed in 2006 and signed into law by Governor
621:
Health Insurance Portability and Accountability Act
407:
377:
367:
357:
347:
339:
334:
261:It has been suggested that this article should be
3470:Supreme Judicial Court for Suffolk County (2009).
3021:"Massachusetts' insured rate hits 98.1%: Analysis"
2775:"Health Safety Net – HSN (Free Care): an overview"
2013:"Uncompensated Care Pool PFY05 Utilization Report"
1827:"Uncompensated Care Pool PFY05 Utilization Report"
1311:are not qualified under their large employer plan,
1193:At the same time, the ACT (Affordable Care Today)
1046:full-time employees provide healthcare insurance.
457:/ State Health Insurance Assistance Program (SHIP)
3618:Commonwealth Health Insurance Connector Authority
3446:"Massachusetts health insurance coverage options"
3048:‘RomneyCare’ – a revolution that basically worked
2745:"Week Beginning March 9, 2008: Facts and Figures"
2287:. Boston, MA: Commonwealth of Massachusetts. 2011
1914:American College of Emergency Physicians (2006).
1291:Commonwealth Health Insurance Connector Authority
318:Commonwealth Health Insurance Connector Authority
2779:Health Care Programs: General – in Massachusetts
2373:
2371:
2188:Helman, Scott; Kowalczyk, Liz (April 13, 2006).
2159:. New York: St. Martin's Press. pp. 53–54.
1725:"Summary of the Massachusetts Health Reform Law"
1665:"Mitt Romney Finally Takes Credit For Obamacare"
1543:Boston Medical Center/BMC HealthNet Plan (BMCHP)
1540:Blue Cross Blue Shield of Massachusetts (BCBSMA)
1160:Emergency Medical Treatment and Active Labor Act
615:Emergency Medical Treatment and Active Labor Act
4017:Healthcare reform in the United States by state
2488:"Massachusetts Health Care Reform Bill Summary"
2781:. Boston: Community Resources Information, Inc
1782:. Boston: Commonwealth of Massachusetts. 2011.
1770:. Boston: Commonwealth of Massachusetts. 2011.
1758:. Boston: Commonwealth of Massachusetts. 2011.
1746:. Boston: Commonwealth of Massachusetts. 2011.
1734:. Boston: Commonwealth of Massachusetts. 2011.
3648:
3522:Priyanka Dayal McCluskey (November 4, 2016).
2722:. Boston: Commonwealth of Massachusetts. 2011
2342:. Boston: Commonwealth of Massachusetts. 2011
2019:. Boston: Commonwealth of Massachusetts. 2011
1963:"Romney's Mission: Massachusetts Health Care"
999:
762:
484:Program of All-Inclusive Care for the Elderly
220:that contextualizes different points of view.
206:to certain ideas, incidents, or controversies
8:
2995:"Short-Term Customers Boosting Health Costs"
2739:
2737:
2691:"PolitiFact | Indeed, abortions are covered"
2330:
2328:
1197:introduced a bill that expanded MassHealth (
317:
3873:No Apology: The Case for American Greatness
2881:. Journalist's Resource.org. April 26, 2011
1210:signatures on the MassACT ballot proposal.
66:Learn how and when to remove these messages
27:2006 healthcare reform law in Massachusetts
3655:
3641:
3633:
2958:American Economic Journal: Economic Policy
2219:Greenberger, Scott S. (November 4, 2005).
1918:. American College of Emergency Physicians
1396:Centers for Medicare and Medicaid Services
1379:Patient Protection and Affordable Care Act
1006:
992:
945:2018 United States Senate election in Utah
780:
769:
755:
645:Patient Protection and Affordable Care Act
633:Patient Safety and Quality Improvement Act
424:
323:
155:. Please do not remove this message until
3266:
3218:
2969:
2925:
2802:"Safety net hospitals strained by reform"
2665:"Outline for new insurance plan proposed"
2591:"Press Release on Fair Share regulations"
1205:) coverage and increased health coverage
443:Federal Employees Health Benefits Program
305:Learn how and when to remove this message
236:Learn how and when to remove this message
175:Learn how and when to remove this message
114:Learn how and when to remove this message
3558:"Access to Health Care in Massachusetts"
2754:. Boston: Massachusetts Health Connector
2429:
2427:
1889:"In Massachusetts, Health Care for All?"
151:Relevant discussion may be found on the
2321:– via The Springfield Republican.
1655:
1592:for failure to state a case upon which
783:
427:
3183:
3172:
796:This article is part of a series about
316:
3997:Medicare and Medicaid (United States)
3734:vice presidential candidate selection
3397:The Henry J. Kaiser Family Foundation
2495:The Massachusetts Law and its History
2131:"Health Care Reform in Massachusetts"
2038:Lieberman, Trudy (January 28, 2010).
1796:"Massachusetts Health Waiver Renewal"
1212:The Blue Cross Blue Shield Foundation
551:Health insurance in the United States
270:Massachusetts 2006 health care reform
7:
3138:"Emergency room visits grow in Mass"
2221:"House approves healthcare overhaul"
1872:"Massachusetts Employer Survey 2010"
1663:Taylor, Jessica (October 23, 2015).
1602:Massachusetts Supreme Judicial Court
1522:Outcomes following transition to ACA
1285:Health Care Quality and Cost Council
352:Public-benefit nonprofit corporation
3741:2012 Republican National Convention
3581:The Health Connector Autopsy Report
3340:Schoenberg, Shira (June 17, 2015).
3019:Geisel, Jerry (December 14, 2010).
2852:Dembner, Alice (February 3, 2008).
2800:Krasner, Jeffrey (March 18, 2008).
2663:Dembner, Alice (January 19, 2007).
1569:A legal challenge was filed in the
478:Children's Health Insurance Program
2565:"Press Release on waiver approval"
2313:. Associated Press. April 26, 2006
1717:For text of the laws, provided by
1549:Harvard Pilgrim Health Care (HPHC)
25:
3611:https://www.brunellemedicaid.com/
3268:10.1016/j.annemergmed.2014.02.011
3097:Massachusetts Taxpayer Foundation
2826:Dembner, Alice (March 26, 2008).
1596:can be granted. A petition for a
1323:subsidy levels for ConnectorCare.
394:, Chair of the Board of Directors
47:This article has multiple issues.
3964:
3954:
3953:
3809:
3497:APPEALS COURT OF MASSACHUSETTS.
2451:2006 Mass. Acts Chp. 58, sec. 12
2442:2006 Mass. Acts Chp. 58, sec. 44
2257:. April 13, 2006. Archived from
1638:
1446:The American Journal of Medicine
1020:Massachusetts health care reform
979:
973:
788:
674:Massachusetts health care reform
252:
191:
130:
77:
36:
3751:2012 U.S. presidential election
3746:Planned presidential transition
3136:Kowalczyk, Liz (July 4, 2010).
2644:. Boston: HCFAMA. March 3, 2007
2497:. Boston: Blue Cross Foundation
2433:2006 Mass. Act Chp. 58, sec. 47
1942:Boston Public Health Commission
932:Planned presidential transition
586:Preferred provider organization
580:Health maintenance organization
574:Exclusive provider organization
429:Healthcare in the United States
55:or discuss these issues on the
3849:Salt Lake Organizing Committee
3604:Massachusetts Health Connector
2486:Blue Cross Foundation (2010).
2403:Mitt Romney (April 11, 2006).
1690:"HHS Poverty Guidelines Chart"
1626:accountable care organizations
1091:Chapter 58 of the Acts of 2006
1051:Massachusetts Health Connector
837:Salt Lake Organizing Committee
545:Private Fee-For-Service (PFFS)
490:Veterans Health Administration
465:Prescription Assistance (SPAP)
1:
4012:Health insurance marketplaces
3579:Lyons, Ed (August 26, 2014).
556:Health insurance marketplaces
3255:Annals of Emergency Medicine
2993:Lazar, Kay (April 4, 2010).
2190:"Joy, worries on healthcare"
1546:Fallon Community Health Plan
520:Health reimbursement account
3992:Healthcare in Massachusetts
3707:2002 gubernatorial election
3299:Annals of Internal Medicine
3155:Miller, Sarah (June 2012).
2405:"Health Care for Everyone?"
1095:Massachusetts General Court
532:High-deductible health plan
378:Public authority executives
157:conditions to do so are met
4033:
3729:2012 presidential campaign
3724:2008 presidential campaign
2773:Massresources.org (2011).
2044:Columbia Journalism Review
1118:time of the reform debate.
1067:emergency medical services
1055:health insurance exchanges
1034:with the aim of providing
1022:, commonly referred to as
734:Fair Share Health Care Act
694:Vermont health care reform
509:Consumer-driven healthcare
437:Government health programs
3949:
3798:
3712:Governor of Massachusetts
3685:Governor of Massachusetts
3670:
3590:MassHealth Advocacy Guide
3220:10.1377/hlthaff.2011.0653
2251:"Back to the Legislature"
2040:"A Tale of Two Jonathans"
1468:A study conducted by the
1452:American Economic Journal
1097:; its long form title is
848:Governor of Massachusetts
706:Municipal health coverage
514:Flexible spending account
335:Public authority overview
322:
3777:2018 senatorial election
3702:1994 senatorial election
2906:Health Services Research
2617:"Commonwealth Care page"
2110:"ACT Health Care Reform"
1645:United States portal
1552:Health New England (HNE)
1528:Kaiser Family Foundation
712:Healthcare in California
3971:Conservatism portal
3476:Public Case Information
2918:10.1111/1475-6773.12228
2713:"Estimate of Uninsured"
2410:The Wall Street Journal
1992:crsreports.congress.gov
915:"Binders full of women"
538:Medical savings account
503:Private health coverage
86:Some of this article's
3805:
3772:2016 anti-Trump speech
3629:. (Various documents).
3574:on September 29, 2007.
3182:Cite journal requires
1624:payment to the use of
1156:United States Congress
940:U.S. Senator from Utah
871:Presidential campaigns
742:(Howard Co., Maryland)
526:Health savings account
469:Military Health System
4002:Universal health care
3940:Ronna Romney McDaniel
3804:
3757:Binders full of women
3076:Beacon Hill Institute
2619:. Health Care For All
1707:. Business Insurance.
1703:Matt Dunning (2013).
1485:Beacon Hill Institute
1443:A study published in
1414:Outcomes prior to ACA
717:Healthy San Francisco
449:Indian Health Service
267:into articles titled
214:by rewriting it in a
2971:10.1257/pol.20150045
1564:Fountas v. Dormitzer
1361:Young adult coverage
1170:economics professor
594:Medical underwriting
400:, Executive Director
3930:(great-grandfather)
3782:Political positions
3450:HealthInsurance.org
3399:. November 29, 2018
2089:Roadmap to Coverage
1841:"CHIA Publications"
1075:Affordable Care Act
819:Political positions
319:
144:of this article is
3828:Bain & Company
3806:
3717:health care reform
3053:2011-10-31 at the
3026:Business Insurance
2748:(MS Word Document)
1369:Changes to the law
1223:individual mandate
863:Health care reform
679:Oregon Health Plan
658:State level reform
607:Health care reform
561:Premium tax credit
415:.mahealthconnector
3979:
3978:
3928:Miles Park Romney
3922:Harold A. Lafount
3787:Electoral history
3261:(2): 107–115.e3.
2379:"Health Care FAQ"
2261:on April 14, 2006
2231:on March 22, 2010
2200:on April 21, 2006
2166:978-1-250-27093-1
1577:, contesting the
1526:According to the
1503:Transition to ACA
1391:Tufts Health Plan
1184:Robert Travaglini
1178:Reform coalitions
1028:healthcare reform
1016:
1015:
967:Anti-Trump speech
824:Electoral history
811:
810:
779:
778:
423:
422:
385:Kathleen E. Walsh
315:
314:
307:
297:
296:
246:
245:
238:
200:This article may
185:
184:
177:
124:
123:
116:
70:
16:(Redirected from
4024:
3969:
3968:
3967:
3957:
3956:
3904:George W. Romney
3813:
3803:
3657:
3650:
3643:
3634:
3628:
3584:
3575:
3573:
3562:
3545:
3540:
3534:
3533:
3529:The Boston Globe
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3431:
3424:The Boston Globe
3415:
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3380:
3378:
3373:. March 24, 2015
3363:
3357:
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3311:10.7326/M13-2275
3296:
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3094:
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3069:
3063:
3059:The Boston Globe
3046:Brian C. Mooney
3044:
3038:
3037:
3035:
3033:
3016:
3010:
3009:
3007:
3005:
2999:The Boston Globe
2990:
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2929:
2897:
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2886:
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2868:
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2864:
2858:The Boston Globe
2849:
2843:
2842:
2840:
2838:
2832:The Boston Globe
2823:
2817:
2816:
2814:
2812:
2806:The Boston Globe
2797:
2791:
2790:
2788:
2786:
2770:
2764:
2763:
2761:
2759:
2749:
2741:
2732:
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2729:
2727:
2717:
2709:
2703:
2702:
2700:
2698:
2686:
2680:
2679:
2677:
2675:
2669:The Boston Globe
2660:
2654:
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2635:
2629:
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2626:
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2613:
2607:
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2554:
2552:
2544:
2538:
2537:
2535:
2527:
2521:
2520:
2519:. July 24, 2011.
2513:
2507:
2506:
2504:
2502:
2492:
2483:
2477:
2476:
2474:
2472:
2467:. Boston: HCFAMA
2466:
2458:
2452:
2449:
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2300:
2294:
2292:
2277:
2271:
2270:
2268:
2266:
2255:The Boston Globe
2247:
2241:
2240:
2238:
2236:
2227:. Archived from
2225:The Boston Globe
2216:
2210:
2209:
2207:
2205:
2196:. Archived from
2194:The Boston Globe
2185:
2179:
2178:
2149:
2143:
2142:
2140:
2138:
2127:
2121:
2120:
2118:
2116:
2106:
2100:
2099:
2097:
2095:
2081:
2075:
2074:
2070:The Boston Globe
2061:
2055:
2054:
2052:
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2029:
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2009:
2003:
2002:
2000:
1998:
1984:
1978:
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1975:
1973:
1959:
1953:
1952:
1950:
1948:
1934:
1928:
1927:
1925:
1923:
1911:
1905:
1904:
1902:
1900:
1895:on April 8, 2006
1891:. Archived from
1885:
1879:
1878:
1876:
1868:
1862:
1861:
1859:
1851:
1845:
1844:
1837:
1831:
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1814:
1806:
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1786:
1783:
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1747:
1735:
1729:
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1700:
1694:
1693:
1686:
1680:
1679:
1677:
1675:
1660:
1643:
1642:
1641:
1598:writ of mandamus
1587:Attorney General
1558:UnitedHealthcare
1461:The Boston Globe
1433:The Boston Globe
1352:Individual taxes
1305:are not working,
1219:Salvatore DiMasi
1079:employer mandate
1036:health insurance
1008:
1001:
994:
983:
977:
807:
806:
804:
797:
792:
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784:
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757:
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393:
327:
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248:
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234:
230:
227:
221:
217:balanced fashion
195:
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173:
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3207:Health Affairs
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3099:. Boston. 2011
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