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High cost, low benefit, health plans under Massachusetts health insurance mandate

The problem with Massachusetts’ mandatory health insurance[Related: CA Legislators Records on H…][Related: Hold Health Insurance Indus…][Related: How Health Insurance Rate R…][Related: CA Legislators Records on H…][Related: Hold Health Insurance Indus…][Related: How Health Insurance Rate R…] law – or any law requiring individuals to buy health insurance – is forcing people to purchase insurance that’s unaffordable, doesn’t provide real coverage, or both.

Massachusetts’ law has a loophole that can force consumers into high-cost, low-benefit "High Deductible Health Plans." These plans are currently exempted from minimum coverage standards, including requirements for preventive care, prescription drugs, and out-of-pocket caps on the amount of money patients can owe. If the HDHP exemption from minimum benefit requirements remains, many more of the uninsured will be forced to purchase supposedly ‘affordable’ HDHP plans with high costs and low benefits.

In comments submitted to the board last week, insurance carriers and businesses urged them to let the exemption stand. They argue that HDHPs give consumers a low-cost option when they’re required to buy private health insurance. But, if consumers are forced to purchase HDHPs as the only ‘affordable’ option under the health mandate law, they’re not getting a choice at all. Consumer advocates argued for this low-benefit loophole to be eliminated. (Download the board’s summary of those comments here.)

The board is starting a meeting right now to discuss amending the rules. They can’t let the HDHP exemption stand and claim they’re requiring minimum benefits for anyone.

Carmen Balber

Consumer Watchdog executive director Carmen Balber has been with the organization for nearly two decades. She spent four years directing the group’s Washington, D.C. office where she advocated for key health insurance market reforms that were ultimately enacted into law as part of the Affordable Care Act.

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