ACA Impact on Mass, Part 1: Low-income Residents will Pay More for Healthcare and Insurance

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Affordability/ Subsidy levels for Low-income: How much will individuals pay for health insurance and health care under the federal law?

Under the ACA, low-income individuals will pay more.

Urban ACA vs MA low-income

Urban report

I don’t recall supporters of the federal law in the Commonwealth highlighting this difference before it passed Congress or leading up to the SCOTUS ruling.

Drilling down to look at cost-sharing as well along with the range of premium payment ranges:

Mass vs Fed

Diff in costs

State Law – CommCare

Federal Law – QHP





138-150% FPL





150-200% FPL





200-250% FPL





250-300% FPL





Source: Connector

The State may have two choices:

1)      Will the state decide to pay for the difference? State reports have shown some interest to pay for additional coverage for those making 200-300% FPL, the estimated cost is roughly $187 million.

In my opinion, it is a good thing for all individuals to pay something for insurance, as it is not free. However, the debate over striking the right balance of affordability and access will once again be ignited under the federal law in Massachusetts.

2)      The state could ask the federal government for a waiver to keep the status quo.

Find me on twitter: @josharchambault