Frequently Asked Questions about mandatory health insurance - Framingham, MA

Interesting article on the mandatory health insurance law in Massachusetts. There are still a couple waivers available if you can't afford the insurance or "if your religion won't let you have health insurance". I have not heard this one before concerning religion so I guess anyone affected by this clause is taken care of under the system? They are making a stab at this ever growing problem though and you can't discount that portion. BD

What are the requirements of Massachusetts Health Care Reform?
All adults are required to have health insurance by July 1. Businesses with 11 or more employees must make a "fair and reasonable" contribution to employee health benefits.
What is the difference between Commonwealth Care and Commonwealth Choice?
Commonwealth Care is a state-subsidized insurance program for uninsured people who have incomes below 300 percent of the poverty rate, which is less than or equal to $30,636. Commonwealth Choice offers new health insurance options to individuals and small employers who do not qualify for Commonwealth Care.
Commonwealth Care plans are offered by Boston Medical Center Health Net Plan, Fallon Community Health Plan, Neighborhood Health Plan and Network Health.
Commonwealth Choice plans are offered by Blue Cross Blue Shield of Massachusetts, Fallon Community Health Plan, Harvard Pilgrim Health Care, Health New England, Neighborhood Health Plan and Tufts Health Plan. A Young Adults Plan is available for 19- to 26-year-olds.
What happens to people who don't get health insurance?
Any Massachusetts adult who does not have insurance as of Dec. 31 will lose their personal exemption on their 2007 state personal income taxes. That exemption gives you a Massachusetts tax savings of approximately $219. In 2008, the cost of the penalty goes up. The fine will equal half of the cost of the lowest-priced Health Connector-certified plan for each month that you don't have coverage.
Are there exceptions?
Yes. If your religion does not allow you to have health insurance, you can file a sworn statement with your state tax return. If you cannot afford health insurance that meets the state's standards, you may file for a waiver with the Health Connector.
What benefits will I need?
Until Jan. 1, 2009, any health insurance plan that is offered by an employer or that can be legally sold in Massachusetts meets the individual mandate. On Jan. 1, 2009, the standards go up. To meet the rules by 2009, you will need a plan that:
1. Covers prescription drugs;
2. Covers regular doctor visits and checkups before any deductible;
3. Caps the deductible at $2,000 for an individual or $4,000 for a family each year;
4. Caps out-of-pocket spending for health services at $5,000 for an individual or $10,000 for a family each year if you have a deductible or co-insurance;
5. Does not cap total benefits for a sickness or for each year; and
6. Does not cap spending toward a day in the hospital.
In addition, any high-deductible health insurance plan that allows you to have a federal Health Savings Account also qualifies.