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Transcript of a chat about the new health insurance law

Dick Powers: Hello to everyone on Boston.com. Eric Dahlberg and I are here to try and provide you with as much information as we can about the new health care law and explain how it affects you. We may not have time to answer all your questions, so please take a few moments to visit our website at www.healthconnector.org or call our customer service center at 1-877-MA-ENROLL. You may also want to look at today's Health Science section in today's Globe for some very good information.

abbey: are they for all kinds of income type?

Dick Powers: Hi Abbey ... yes, they are. There are two programs. Commonwealth Care is the subsidized program for folks earning under 300 percent of the federal poverty level. Premiums start at zero and scale up to $105 per person, depending on income. Commonwealth Choice is the unsubsidized program just launched May 1. And, yes, we are coninviced they are affordable for most, but if you don't think it is affordable for you, you should apply for a waiver.

Bob: I have insurance through my job - do I have to do anything to make sure it's adequate and meets the new standards?

Dick Powers: Hi Bob ... you would be in compliance until at least Jan. 1, 2009, when the more stringent standards for minimum creditable coverage kick in. Check with your employer to see if your current policy meets the 1/1/09 requirements. If not, you should buy coverage during your next open enrollment period that would meet the new standards.

JT: What resources do I have if I cannot afford health insurance?

Dick Powers: For low-wage earners, there is MassHealth. Also, CommCare premiums start at zero and gradually ramp up as you earn more money. If you still think insurance is unaffordable to you, apply for a waiver.

guadalupe: I noticed that after 12/2008, there will a monthly penalty if you don't have insurance -- what is that penalty?

Dick Powers: Guadalupe ... For the first year, you will lose the personal exemption on your tax return, $219. But in subsequent years, it will increase dramatically. The penalty will then be up to one-half the cost of the least expensive plan available to you per month that you are uninsured.

westma: Where can I go to enroll?

Dick Powers: Hi Westma ... you should visit our website, www.mahealthconnector.org or call our toll-free number, 1-877-MA-ENROLL.

Dirk: I'm a young man in good health. I CHOOSE to NOT pay for health care. Why is Mass. forcing me to pay for insurance that I simply won't use?

Dick Powers: Dirk ... glad to hear you're in good health, but you never know what's going to happen when you step off the curb. If that happens, you will expect an ambulance to pick you up and a hospital to treat you. Someone is going to be paying that bill. It is also important that we get everyone into the risk pool, since this will keep premiums affordable for everyone.

elle: Are these plans comprehensive enough for disabled individuals?

Dick Powers: Hi Elle ... yes, these plans include all benefits required by law in Massachusetts and pre-existing conditions cannot prevent you from buying health insurance.

John: Dick, are you addressing the issue of limited Primary care Providers and especially limuted Specialists in the new Commonwealth Care/Choice packages? As more people sign up for these plans, the problem could become a crisis.

Dick Powers: Hi John ... you raise a very valid point that we are not directly in a position to address. However, it is not as though uninsured people have been going without treatment. They have been seeing doctors through the uncompensated care pool. So, one way or another people have been seeing doctors so I don't believe more people having insurance will cause a crisis ... but I do think you raise a good point.

CJ: What if you have been laid off from your job and are unemployed do you still have to buy coverage?

Dick Powers: Hi CJ ... two possibilities. If you have no income, you may qualify for Commonwealth Care, our subsidized program. Premiums start at zero. The other possibility is to obtain a waiver. I would suggest looking into CommCare rather than the waiver, because you're much better off if you have insurance.

Em: I am a self-employed educati.......onal consultant. I have health insurance.... through my wife's employment, paying through payroll deduction. Am I eligible for individual .............coverage and how can I research the cost............................?

Dick Powers: Hi Em ... from what you tell us, you could certainly qualify for Commonwealth Choice. Please visit our website at www.mahealthconnector.org. We think you'll find the website a pleasant shopping experience. Some have referred to it as the Travelocity of health insurance.

Dick Powers: www.mahealthconnector.org

dubstyle: Is there a website I can go to to read all about the new health insurance law?

Dick Powers: www.mahealthconnector.org

kay: If I know I'm going to have a lag of insurance -- between jobs -- do I have to sign up for a plan even though it's only going to be a month?

Dick Powers: Hi Kay ... small lags in coverage are allowed under the law, but you still run the risk of being uninsured. It would be your call whether or not you wanted to be uninsured for that month.

Shallimar: Hello. I have several questions. I wil ask one at a time-my current BC/BS policy is being cancelled-I am trying to choose a PPO plan now that will met 1/09 Mass. eligibility reqmts. so I don't have to do it again-Many options I am considering meet the standards of a max. $2000 ded. & a cap on $5,000 out of pocket max. However,re: reqmt. that routine/preventive care visits may have no ded. applied- there are some policies that do not met that reqmt in full- I was told there would be waivers/exceptioons-how do I find out what they are? Some meet the reqmt only in-network, some say there are still services u may have to pay for- I have another question but please address this issue firstilit

Dick Powers: Hi Shallimar ... These are great questions. Through December '08, any health insurance policy will meet the mandate. As you correctly note, standards tighten up in 1/09. If your policy does not meet those standards, you will be subject to a penalty. Stay tuned to our website for more info on how and when to apply for waivers.

kay: Is the website the only place I can sign up for a plan?

Dick Powers: Hi Kay ... you can also purchase directly from insurance carriers.

John: Dick, you mentioned that some one qualified for Commonwealth Choice. Doesn't everyone qualify for Commonwealth Choice?

Dick Powers: CommChoice is available to all residents of Massachusetts with some exceptions based on employer size and whether the employer offers health insurance. Of course, Young Adult Plans are only available to people between the ages of 19 and 26 who are not offered employer-sponsored health insurance.

i_heart_d_powers: If my employer offers insurance, but it does not qualify as "full coverage" for me in '09 , will my employer pay a fine? If not, why the gap?

Dick Powers: Government, employers and employees all have specific responsibilities under health care reform. Certain businesses must make a fair and reasonable contribution to plans or face the fair share assessment. They must also allow their employees to purchase health insurance on pre-tax basis or face the free rider surcharge. It is up to the individual, however, to make certain that his or her plan meets minimum creditable coverage standards. If it doesn't, the individual will possibily be subject to a penalty.

kay: How do I find out if I qualify for Commonwealth Choice? Website again? :-)

Dick Powers: www.mahealthconnector.org

SuzieQ: Is this law subject to an age requirement? Will parents be penalized for not insuring their children if they do not buy a family insurance plan?

Dick Powers: Hi SuziQ ... The individual mandate applies to adults, 18 years of age and older. The individual mandate does not apply to children. Fortunately, Massachusetts has one of the best insured rates for children in the country. The health care reform law also expanded MassHealth coverage for children up to 300 percent of the fedeal poverty level, which is $61,950 for a family of four.

kay: Do I have to get coverage as a part-time employee?

Dick Powers: If you're an adult in Massachusetts, you have to get affordable coverage. If it's not affordable, you may receive a waiver.

Brit: What about employees who are covered under an employer who is self-insured? Is it true that my employer is not subject to the new health insurance law?

Dick Powers: Hi Brit ... there are a lot of "what ifs" required to give you a full answer. I'd suggest you call our toll-free number and have a conversation with one of our representatives, who can answer your specific concerns. That number is 1-877-MA-ENROLL.

sunny: I'm looking at moving to MA next year and am concerned about what I have to do about signing up for this once I'm in state. Is there a time limit to how long I have before having insurance when I move?

Dick Powers: Hi Sunny ... Brief lags in coverage are permissable under the law, but the mandate applies to most adult residents.

Dick Powers: We appreciate all the thoughtful questions today. I can't suggest strongly enough that you visit our website at www.mahealthconnector.org. If you don't find what you're looking for there, give us a call at 1-877-MA-ENROLL. Thanks for taking the time to chat. We look forward to doing this again.

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