Section 81 ConnectorCare Pilot Program
(a) Notwithstanding subsection (b) of section 3 of chapter 176Q of the General Laws or any other general or special law to the contrary, not later than January 1, 2024, the commonwealth health insurance connector authority, established in section 2 of said chapter 176Q, shall implement a 2-year pilot program to extend eligibility for premium assistance payments or point-of-service cost-sharing subsidies for applicants at or below 500 per cent of the federal poverty guidelines.
(b) Applicants participating in the pilot program that are between 300 and 500 per cent of the federal poverty guidelines shall have access to a plan that meets at least 90 per cent actuarial value; provided, that the affordability standard for the pilot program shall be consistent with current practices pursuant to said section 3 of said chapter 176Q.
(c) Notwithstanding the second paragraph of section 2OOO of chapter 29 of the General Laws or any other general or special law to the contrary, amounts necessary to support the 2-year pilot program established in subsection (a) shall be expended from the Commonwealth Care Trust Fund, established in said section 2OOO of said chapter 29.
(d) The commonwealth health insurance connector authority, in consultation with the center for health information and analysis, established in section 2 of chapter 12C of the General Laws, shall evaluate the pilot program to assess the public health, health equity, utilization and financial impacts on residents of reducing out-of-pocket costs and premium costs. The authority, in consultation with the center, shall collect quantitative and qualitative data at the start of the pilot program and at the end of each calendar year of the pilot program to assess the impact on pilot program participants. Data points to be collected, to the extent feasible, shall include, but not be limited to: (i) rates of unmet medical needs due to cost; (ii) disparities in rates of unmet medical needs due to cost; (iii) difficulties accessing care at a doctor's office or clinic; (iv) racial and ethnic disparities in difficulties accessing care at a doctor's office or clinic; (v) insurance coverage rates, including rates of continuous insurance coverage; (vi) racial and ethnic disparities in insurance coverage rates; (vii) visits to a doctor's office, including, but not limited to, the number of visits, frequency of visits and any relevant data related to the visits; and (viii) racial and ethnic disparities in visits to a doctor's office. The authority shall file reports of its evaluation with the clerks of the house of representatives and the senate, the house and senate committees on ways and means, the joint committee on public health and the joint committee on health care financing not later than July 1, 2025 and July 1, 2026.
(e) The commonwealth health insurance connector authority shall promulgate any rules or regulations necessary for the implementation and administration of this section.