Massachusetts has been given an additional year to comply with the Affordable Care Act, following a trend of deadline extensions. Initially granted a one-year extension in 2013, they have now been granted another year to get the program aligned with federally mandated standards. Governor Baker has asked for an “indefinite extension” citing that the reduction of qualifiers used to determine premiums could cause a ripple effect of “instability” in the insurance marketplace. The new deadline allows them until January of 2018 to fully comply with ACA requirements.
Currently, Massachusetts Health Connector uses nine identifiers to determine health premiums, under Obamacare, that number would need to be reduced to four—only age, family size, geographic area, and tobacco use would be considered. The extension allows insurance companies to use their full range of factors—such as industry, group size, and participation rate—until 2017 when determining health care premiums. Another point of contention is the definition of small businesses under the ACA requirements. Governor Baker has asked that the definition of a small business in Massachusetts remains 50 employees rather than the ACA specified 100 employees.
The hope is that these allowances will help prevent small business from falling prey to huge rate hikes in insurance and the associated risk of having to downsize or even close shop should the premiums become too large for a small business to afford. Administrators from both sides have continued to negotiate the specifics of the requirements over the last few weeks.
This is just the latest chapter in the story of MassHealth’s continued difficulties complying to the federal ACA requirements and regulations. Just last month it was reported that the US attorney served a subpoena in January of 2015 for the Massachusetts Health Connector records dating back to 2010 in an attempt to figure out the difficulties MassHealth has encountered when trying to meet the ACA regulations. Massachusetts’ continued trouble complying with the ACA is an interesting puzzle, given that the ACA was modeled in large part after Massachusetts law, Chapter 58: An act Providing Access to Affordable, Quality, Accountable Health Care. This leaves one to wonder whether there are true difficulties with and concerns about the ACA regulations or whether the changing winds of political rhetoric and special interests are at the source of these current difficulties.