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SENATE DOCKET, NO. 1954 FILED ON: 1/20/2023
SENATE . . . . . . . . . . . . . . No. 735
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
John J. Cronin
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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act providing affordable care through out-of-pocket assistance.
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PETITION OF:
NAME:DISTRICT/ADDRESS :John J. CroninWorcester and MiddlesexJoanne M. ComerfordHampshire, Franklin and Worcester2/28/2023 1 of 2
SENATE DOCKET, NO. 1954 FILED ON: 1/20/2023
SENATE . . . . . . . . . . . . . . No. 735
By Mr. Cronin, a petition (accompanied by bill, Senate, No. 735) of John J. Cronin and Joanne
M. Comerford for legislation to provide affordable care through out-of-pocket assistance. Health
Care Financing.
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Third General Court
(2023-2024)
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An Act providing affordable care through out-of-pocket assistance.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. (a) Notwithstanding any other general or special law to the contrary, the
2Secretary of Health and Human Services, in consultation with the commonwealth health
3insurance connector authority established in section 2 of chapter 176Q shall implement a cost-
4sharing assistance program for applicants at or below 500 percent of the federal poverty
5guidelines enrolled in employer-sponsored insurance plans.
6 (b) Applicants shall be deemed eligible for the cost-sharing assistance program
7established under subsection (a) of section 1 if they meet the following criteria: (1) have income
8under 500 percent of the federal poverty level; and (2) are enrolled in an employer sponsored
9health insurance plan that meets the criteria for minimum value and affordable coverage under
10U.S. Code section 36B(c)(2)(C).
11 (c) The cost-sharing assistance program established under subsection (a) shall provide
12supplemental insurance coverage to eligible applicants that covers the differences in cost- 2 of 2
13sharing, including co-pays, co-insurance, and deductibles, between the employer plan in which
14the applicant is enrolled, and a plan equivalent to plans sold through the connector that are
15eligible for premium assistance payments or cost sharing subsidies under section 3 of Chapter
16176Q.
17 (d) The commonwealth health insurance connector authority, in consultation with the
18center for health information and analysis, shall evaluate the cost assistance program to assess
19the public health, health equity, utilization and financial impacts on residents of reducing out-of-
20pocket costs. The center shall collect quantitative and qualitative data at the start of the program
21and at the end of each year of the program to assess the impact on program participants. Data
22points to be collected shall include, but not be limited to: (i) rates of unmet medical need due to
23cost; (ii) disparities in rates of unmet medical need due to cost; (iii) difficulties accessing care at
24a doctor’s office or clinic; (iv) racial and ethnic disparities in difficulties accessing care at a
25doctor’s office or clinic; (vii) visits to a doctor’s office; and (viii) racial and ethnic disparities in
26visits to a doctor’s office. The connector authority shall file a report of its evaluation with the
27clerks of the house of representatives and the senate, the house and senate committees on ways
28and means, the joint committee on public health and the joint committee on health care financing
29not later than December 1, 2029.
30 SECTION 2. Section 1 shall take effect on Jan 1, 2026.