National Health Care Reform

Helping individuals and families access affordable and comprehensive health insurance

A man smiling in front of his home

National health reform helps families pay for health insurance by making new subsidies and tax credits available to millions of people. The law also takes important steps to ensure that the coverage available for individuals and families includes meaningful consumer protections.

More Affordable Health Insurance

More People Qualify for Medicaid

Prior to national health reform, eligibility for the state’s Medicaid program, MassHealth, was limited to certain categories of people, such as pregnant women, children under 19 and their parents, the disabled and the elderly, if their income met certain requirements. Beginning in 2014, as a result of national health reform, all Massachusetts residents under 133 percent of the federal poverty level (FPL) will be eligible for MassHealth if they are citizens or qualified aliens. For example, a family of four that makes less than $31,000 a year may qualify for MassHealth.

Tax Credits to Help Pay for Insurance

New federal tax credits designed to help people pay for their health insurance premiums will also become available. Prior to passage of the ACA, individuals and families in Massachusetts earning up to 300% FPL (about $35,640 for an individual and $72,900 for a family of four) could get help paying for their health insurance premiums.

People with incomes up to 400% of the federal poverty level (about $47,520 for an individual and $97,200 for a family of four) may qualify for federal tax credits to lower the cost of their premiums when they purchase insurance plans through the Health Connector.

State-Subsidized Health Plans

In addition to federal tax credits, Massachusetts offers additional savings to those who are eligible (those earning up to 300% FPL). ConnectorCare plans are a set of health insurance plans with lower premiums and lower out-of-pocket costs that are subsidized by the state, as well as by the federal government through national health reform. By shopping through the Health Connector, individuals can easily and quickly find out if they qualify for one of these plans.

Special Note: The Massachusetts 2018 open enrollment ended January 23, 2018. But, Massachusetts residents can enroll any time of the year if they experience a qualifying event, is eligible for MassHealth, CMSP, ConnectorCare plans, or would like to purchase a dental plan. Find out more now →

More Comprehensive Coverage

National health reform strengthens consumer protections and ensures that health insurance provides comprehensive coverage. While some of the insurance changes introduced by national health reform were already in place in Massachusetts, new consumer protections mean even better benefits for Massachusetts residents.

These include:

  • Coverage of preventive care services with no cost-sharing
  • No annual limits on benefits considered “Essential Health Benefits”
  • No lifetime limits on benefits
  • The ability for young people to stay on their parents’ coverage until age 26
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