health and counseling edition - the Youth Advocacy Division

FALL 2008
COMMUNITY NOTEBOOK: HEALTH AND COUNSELING EDITION
HEALTH CARE REFORM IN MASSACHUSETTS: HOW ARE ADOLESCENTS AFFECTED
Kim Simonian, MPH
In April 2006, the Commonwealth of
Massachusetts passed Chapter 58: An Act
Providing Access to Affordable, Quality,
Accountable Health Care. This legislation has
become known as the Health Care Reform Law
and its implementation is being watched
nationally as other states contemplate similar
efforts. Massachusetts is under pressure to
succeed.
Having just celebrated its two-year
anniversary, the Health Care Reform Law has
certainly succeeded in its first goal: to enroll
uninsured Massachusetts residents in appropriate
health coverage. Since April 2006, 340,000
residents are newly-insured as a result of health
care reform. The state’s next goal will be to
contain rising health care costs and maintain
quality in such a way that this coverage is
sustainable.
What does this legislation mean for
adolescents and young adults who might be
uninsured Generally speaking, there are more
health coverage options available for everyone
living in Massachusetts, and more opportunities for
adolescents and young adults to secure health
insurance. Consider the following programs:
MassHealth
Health Care Reform expanded eligibility
for MassHealth—the state’s Medicaid program.
Kim Simonian is Manager of Public Payer
Policy and Operations for Partners
HealthCare’s Community Benefits Program.
Full health coverage under MassHealth is
available to parents living with dependents under
age 19, to children under age 19 who do not live
with their families, and to disabled children.
Applicants must fall within income eligibility
guidelines, which vary depending on the
household size. Children are eligible if their family
income is less than 300% of the federal poverty
level—about $63,600 for a family of four or $31,200
for an individual. Additionally, families who meet
these income requirements but who already have
private health insurance may qualify for help with
their private insurance premium payments.
For more information on MassHealth
eligibility, visit www.mass.gov/masshealth or call
the MassHealth Customer Service line at (800) 841-
2900.
Children's Medical Security Plan (CMSP)
CMSP continues to be available for all
children under age 19 who are not eligible for
MassHealth or do not have access to comparable
primary and preventive health insurance.
Children are eligible regardless of family income
or immigration status, and are subject to monthly
premiums and co-payments depending on family
income.
For more information on CMSP eligibility,
visit www.mass.gov/masshealth or call the
MassHealth Customer Service line at (800) 841-
2900 .
Commonwealth Care
Commonwealth Care plans are new
health insurance plans that are offered by the
state’s Commonwealth Health Insurance
Connector Authority, or “The Connector”. These
plans are for individuals age 19 and older who are
uninsured and lack access to any other insurance.
As with MassHealth, individuals must earn less than
300% of the federal poverty level in order to
qualify, and may be required to pay monthly
premiums and co-payments, depending on their
income level.
For more information on Commonwealth
Care eligibility, visit www.mahealthconnector.org
or call the Connector Helpline at (877)-623-6765.
Young Adult Plans
There are many residents of
Massachusetts who do not meet the income
guidelines for MassHealth or Commonwealth
Care, but who cannot afford health insurance.
These individuals may purchase new
Commonwealth Choice health plans. There are
special Commonwealth Choice plans for 18-26
year olds, called Young Adult Plans. These are
private health plans, offered through Blue Cross
Blue Shield of Massachusetts, Fallon Community
Health Plan, Harvard Pilgrim Health Plan, Health
New England, Neighborhood Health Plan, and
Tufts Health Plan. Plans have some monthly
premiums, co-payments, and limits on benefits.
For more information on Young Adult
Plans, visit www.mahealthconnector.org and click
on “Young Adults” or call the Connector Helpline
at (877) 623-6765.
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