Another state is making some benefits history. Massachusetts has passed legislation (House No. 4850) that would require most of its citizens to purchase health insurance. The legislation would also require employers with 11 or more employees to contribute towards the cost. I am sure that the legislation will give rise to a lot of discussion over ERISA preemption issues just as the Maryland legislation did when it was passed late last year (discussed here and here).
The Wall Street Journal in an article yesterday provided this summary of the Massachusetts legislation:
Under the plan approved yesterday, uninsured residents who don’t buy new, low-cost plans — some subsidized by the state — would face financial penalties beginning in July 2007. In the first year, those who don’t buy insurance — provided the state makes available one deemed affordable — forfeit their personal state tax exemption, now worth about $150. In the second year, those who don’t buy would have to pay a fine equal to half of the monthly premium cost of an affordable plan. For a full year, the fine could total about $1,200 for a young adult who would be eligible for an individual plan. There are no criminal penalties for not buying insurance.In another provision that stirred unease among some businesses, the proposed law would require companies with 11 or more employees to provide health coverage or pay a per-employee annual fee of $295. In addition, employers whose uninsured workers make multiple use of emergency room care — “free riders,” in the bill’s parlance — would have to pay between 10% and 100% of the portion of those medical bills exceeding $50,000.
The Wall Street Journal also reports that “Massachusetts faced a July federal deadline to show that it was working to cover more of the uninsured or face losing $385 million in funding for Medicaid, the federal-state insurance plan for the poor and disabled” and that “[o]ther states — schedules vary from state to state — are expected to face similar pressure in coming years.”
You can access links to the legislation at the website of the The 184th General Court of The Commonwealth of Massachusetts:
- Full text of legislation
- Conference Committee Report, Section-by-Section Summary
- Summary and Fact Sheet
One of the most interesting parts of the legislation is that every employer with 11 or more employees would be required to adopt a 125 plan. Employers who don’t comply would be faced with a fine. Bill section 48 provides as follows:
Section 2. Each employer with more than 10 employees in the commonwealth shall adopt and maintain a cafeteria plan that satisfies 26 U.S.C. 125 and the rules and regulations promulgated by the connector. A copy of such cafeteria plan shall be filed with the connector.
If you are wondering what the term “Connector” means like I did, here’s what the Fact Sheet says about that term:
The bill creates the Commonwealth Health Insurance Connector, to connect individuals and small businesses with health insurance products. The Connector certifies and offers products of high value and good quality. Individuals who are employed are able to purchase insurance using pre-tax dollars. The Connector allows for portability of insurance as individuals move from job to job, and permits more than one employer to contribute to an employee’s health insurance premium. The Connector is to be operated as an authority under the Department of Administration and Finance and overseen by a separate, appointed Board of private and public representatives.
Health savings accounts have also been allowed to play a roll in the legislation. The bill would apparently enable HMOs to offer coverage plans that are linked to health savings accounts.
Some pertinent links:
- Kaisernetwork.org reports here on the legislation.
- Professor Secunda discusses ERISA preemption at the WorkforceProf Blog.
- NCSL is keeping tabs on “Pay or Play” legislation here.
- More links at Affordable Care Today.