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| Mr. and Mrs. Mallard hunt for coverage |
Predating and existing alongside the ACA marketplace, Massachusetts implemented and has maintained a better system.
At incomes up to the 300% of the Federal Poverty Level, Massachusetts applicants who earn too much to qualify for Medicaid are offered a standard, easily comprehensible benefit package with low premiums and out-of-pocket costs. That contrasts with the ACA's bewildering array of sometimes more than 100 plans in four metal levels, each offering a smorgasbord of copays and coinsurance, often with high but Swiss-cheese deductibles to which many services are not subject.
As measured by actuarial value -- the percentage of the average enrollee's annual costs* the plan is designed to pay -- ConnectorCare offers more generous coverage than the ACA's benchmark silver plans (which are enhanced by Cost Sharing Reduction subsidies at incomes up to 250% FPL) at every income at which it's available. The AV difference is nominal at the 100-150% FPL income level, pronounced at 150-200% FPL, and enormous at 200-300% FPL, as illustrated below (via a 2021 program overview). Equally important, enrollees are not lured by bronze or gold plans with radically higher out-of-pocket exposure.
