Basics on Health Care Reform for Individual Artists and
History of our state's health care reform: In
April 2006, a piece of sweeping bipartisan supported Health Care Reform
Legislation (known as Chapter 58 of the Acts of 2006) became law. This
law has changed health care in Massachusetts and beyond. The key goal
of this law was to move closer to universal coverage in this state by
reducing the overall number of the uninsured in Massachusetts (which
is estimated at 10 percent of the population). The responsibility for
paying for the implementation of this new law has been spread to many
sectors- individuals, employers, and the state government.
law created a new independent State agency called the Commonwealth Health
Insurance Connector Authority (the Connector). This organization is
charged with implementation of the law and for creating the policies,
programs, and regulations to make this law a reality. The Connector
is also charged to set the standards that define what "creditable
and affordable" health insurance coverage is for the State. This
is also referred to as Minimum Creditable Coverage or MCC (in other
words health insurance products purchased by individuals who are state
residents will have to meet the MCC standards set by the Connector).
Connector's mission, as stated on their web site is: "Promoting
health care coverage across the Commonwealth ...The Connector serves
as a bridge between eligible individuals, small employers, and health
plans to promote affordable private health insurance to uninsured residents
of Massachusetts. The Connector is overseen by a board of ten directors.
Six directors represent diverse types of expertise and interests from
the private sector, three of whom are appointed by the Governor and
three by the Attorney General. It is managed by an Executive Director
who reports to the Board of Directors.
One key component of this law is the "individual mandate." Massachusetts residents age 18 and older
are required to have health insurance that is deemed affordable
to them at their income level or they risk being fiscally penalized
on their personal income taxes.
National healthcare reform history: It
is important to be aware in 2010, the Federal Government passed what is known as the Affordable Care Act (the ACA or Obama Care). This law is modeled on our State's Heatlh Care Reform law (people can't be excluded from coverage for a pre-existing condition, children can stay on their parents insurance until age 26, etc) and its keeps many of the requirements MA has (individual mandate, etc).
One key improvement of the ACA was that Modified Adjusted Gross Income (MAGI) is now the measure used to see if individuals are eligible for subsidies/tax credits to pay for their insurance. This is very helpful for those who are self-employed or have 1099 income. To learn what MAGI is: http://laborcenter.berkeley.edu/pdf/2013/MAGI_summary13.pdf
Those whose income
is not solely from W-2 income sources with regular pay stubs (ie those who are self-employed, seasonal workers,
don't have regular pay stubs, and/or have combination income sources
(W-2 income, 1099 income, etc.), should
contact an enrollment specialist in person to determine what their income
is. (Contact Health Care for All's Help line or an enrollment specialist
at a community health center, hospital, or at a health care advocacy
The Connector website is a key market place for one to buy health insurance (subsidized or not subsized). It is the only site to be able to buy subsidized/tax credit supported health plans (again if you have hard to determing income work with an enrollment specialist to see if you qualify for help paying for your health insurance). Note
you can buy unsubsized Health Plans directly from the insurance carriers, through brokers
and not through the Connector (but make sure the plans you buy meet Massachusetts' requirements).
*PLEASE be aware that the rules for when someone can purchase insurances as an individual on the private market has drastically changed. There is now an annual open enrollment period and if you miss that enrollement period and you do not have what is called a "qualifying event"- you can't buy insurance! More on this in the issue on this page and what you an do: Private Insurance Rules.*
contact the Connector- Information
and enrollment material is available online at www.MAhealthconnector.org
or by calling the Health Connector's customer service center weekdays
Given the uncertainty with the Trump administration's support of the ACA, we strongly recommend that artists who have hard to determine income
DO NOT enroll or sign up for any program/health insurance plan via the
Connector's website or phone lines. Only use the Connector as a way
to research your options. This is very important. It is best if you
talk to a seasoned enrollment specialist from Health Care for All's
FREE Helpline (1-800-272-4232) or enroll through an health care advocate
at a health center, health agency or hospital to see if you are first
eligible for a subsidized health plan and if you find out that you are
not eligible THEN use the Connector to enroll in a non subsidized health
plan. It is important to be able to
have an enrollment specialist to be able to advocate on your behalf
or with you if something does not go smoothly with your enrollment.
information on this site is intended only for educational purposes and
is not meant to be legal and/or tax advice. All information on this
site may be reproduced for educational purposes with permission from
Healthcare for Artists. No permission is needed for it to be downloaded/printed
out for individual use. If you have questions after reviewing the information
provided on this site, it is best to call an enrollment specialist or
a staff person at a designated state agency or advocacy organization.