Bill > H1246

This bill establishes a public health insurance option in Massachusetts through the Commonwealth Connector Authority, designed to provide an additional affordable health insurance choice for residents. The public option will be available to eligible individuals and small groups starting January 1, 2027, and to large groups by July 1, 2027. The plan will be offered exclusively through the Connector and must meet the same quality and coverage standards as other approved health plans. The Commonwealth Connector is authorized to contract with Medicaid managed care organizations to administer the plan, with potential for other organizations to apply after January 1, 2027. Premium rates will be set to fully cover health benefits and administrative costs, and provider reimbursement will be based on Medicare rates with potential adjustments to ensure a strong provider network. Healthcare providers participating in Medicare will automatically be included in the public option unless they choose to opt out through a process established by the Connector. The bill also creates a Public Health Insurance Option Trust Fund to support the program's operation and includes provisions for risk adjustment among health plans to help balance financial risks. A key goal of the legislation is to increase healthcare choice, competition, and stability in Massachusetts' health insurance market.

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https://malegislature.gov/Bills/194/H1246