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| 2 | 2 | | SENATE DOCKET, NO. 1954 FILED ON: 1/20/2023 |
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| 3 | 3 | | SENATE . . . . . . . . . . . . . . No. 735 |
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| 4 | 4 | | The Commonwealth of Massachusetts |
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| 5 | 5 | | _________________ |
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| 6 | 6 | | PRESENTED BY: |
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| 7 | 7 | | John J. Cronin |
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| 8 | 8 | | _________________ |
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| 9 | 9 | | To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General |
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| 10 | 10 | | Court assembled: |
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| 11 | 11 | | The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill: |
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| 12 | 12 | | An Act providing affordable care through out-of-pocket assistance. |
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| 13 | 13 | | _______________ |
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| 14 | 14 | | PETITION OF: |
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| 15 | 15 | | NAME:DISTRICT/ADDRESS :John J. CroninWorcester and MiddlesexJoanne M. ComerfordHampshire, Franklin and Worcester2/28/2023 1 of 2 |
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| 16 | 16 | | SENATE DOCKET, NO. 1954 FILED ON: 1/20/2023 |
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| 17 | 17 | | SENATE . . . . . . . . . . . . . . No. 735 |
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| 18 | 18 | | By Mr. Cronin, a petition (accompanied by bill, Senate, No. 735) of John J. Cronin and Joanne |
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| 19 | 19 | | M. Comerford for legislation to provide affordable care through out-of-pocket assistance. Health |
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| 20 | 20 | | Care Financing. |
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| 21 | 21 | | The Commonwealth of Massachusetts |
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| 22 | 22 | | _______________ |
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| 23 | 23 | | In the One Hundred and Ninety-Third General Court |
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| 24 | 24 | | (2023-2024) |
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| 25 | 25 | | _______________ |
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| 26 | 26 | | An Act providing affordable care through out-of-pocket assistance. |
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| 27 | 27 | | Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority |
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| 28 | 28 | | of the same, as follows: |
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| 29 | 29 | | 1 SECTION 1. (a) Notwithstanding any other general or special law to the contrary, the |
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| 30 | 30 | | 2Secretary of Health and Human Services, in consultation with the commonwealth health |
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| 31 | 31 | | 3insurance connector authority established in section 2 of chapter 176Q shall implement a cost- |
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| 32 | 32 | | 4sharing assistance program for applicants at or below 500 percent of the federal poverty |
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| 33 | 33 | | 5guidelines enrolled in employer-sponsored insurance plans. |
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| 34 | 34 | | 6 (b) Applicants shall be deemed eligible for the cost-sharing assistance program |
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| 35 | 35 | | 7established under subsection (a) of section 1 if they meet the following criteria: (1) have income |
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| 36 | 36 | | 8under 500 percent of the federal poverty level; and (2) are enrolled in an employer sponsored |
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| 37 | 37 | | 9health insurance plan that meets the criteria for minimum value and affordable coverage under |
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| 38 | 38 | | 10U.S. Code section 36B(c)(2)(C). |
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| 39 | 39 | | 11 (c) The cost-sharing assistance program established under subsection (a) shall provide |
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| 40 | 40 | | 12supplemental insurance coverage to eligible applicants that covers the differences in cost- 2 of 2 |
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| 41 | 41 | | 13sharing, including co-pays, co-insurance, and deductibles, between the employer plan in which |
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| 42 | 42 | | 14the applicant is enrolled, and a plan equivalent to plans sold through the connector that are |
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| 43 | 43 | | 15eligible for premium assistance payments or cost sharing subsidies under section 3 of Chapter |
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| 44 | 44 | | 16176Q. |
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| 45 | 45 | | 17 (d) The commonwealth health insurance connector authority, in consultation with the |
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| 46 | 46 | | 18center for health information and analysis, shall evaluate the cost assistance program to assess |
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| 47 | 47 | | 19the public health, health equity, utilization and financial impacts on residents of reducing out-of- |
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| 48 | 48 | | 20pocket costs. The center shall collect quantitative and qualitative data at the start of the program |
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| 49 | 49 | | 21and at the end of each year of the program to assess the impact on program participants. Data |
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| 50 | 50 | | 22points to be collected shall include, but not be limited to: (i) rates of unmet medical need due to |
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| 51 | 51 | | 23cost; (ii) disparities in rates of unmet medical need due to cost; (iii) difficulties accessing care at |
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| 52 | 52 | | 24a doctor’s office or clinic; (iv) racial and ethnic disparities in difficulties accessing care at a |
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| 53 | 53 | | 25doctor’s office or clinic; (vii) visits to a doctor’s office; and (viii) racial and ethnic disparities in |
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| 54 | 54 | | 26visits to a doctor’s office. The connector authority shall file a report of its evaluation with the |
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| 55 | 55 | | 27clerks of the house of representatives and the senate, the house and senate committees on ways |
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| 56 | 56 | | 28and means, the joint committee on public health and the joint committee on health care financing |
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| 57 | 57 | | 29not later than December 1, 2029. |
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| 58 | 58 | | 30 SECTION 2. Section 1 shall take effect on Jan 1, 2026. |
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