The Massachusetts Commonwealth Health Insurance Connector board, which is responsible for overseeing the implementation of the state's health insurance law, on Thursday approved 28 low-cost plans offered by seven insurers, USA Today reports. The plans will range in price from $122 to more than $800 a month, depending on age and level of coverage (Appleby, USA Today, 3/9). Under the state's health insurance law, all residents must obtain coverage by July 1 or face tax penalties. The plans approved on Thursday, called Commonwealth Choice plans, are intended for uninsured residents whose annual incomes are too high to qualify for state-subsidized health coverage. The plans have three basic designs, with "bronze" level plans having lower monthly premiums but higher out-of-pocket expenses in the form of copayments, deductibles and co-insurance. "Gold" level plans will have higher premiums but fewer out-of-pocket expenses. All plans offer comprehensive benefits as determined by the Connector board, including doctors' visits, hospital stays, outpatient surgery, prescription drugs, physical therapy and diagnostic tests. Insurers participating in the plans are: Blue Cross and Blue Shield of Massachusetts and Harvard Pilgrim Health Care, both of which will offer statewide coverage, ConnectiCare, Fallon Community Health Plan, Health New England, Neighborhood Health Plan and Tufts Health Plan, all of which will offer regional coverage (Krasner, Boston Globe, 3/9). Residents will be able to sign up for the plans beginning in May (USA Today, 3/9).

Penalty Exemptions
State officials have said they would consider exempting some residents from the insurance requirement amid "growing criticism about the plans' affordability," the Boston Globe reports (Boston Globe, 3/9). State Sen. Mark Montigny (D) said, "There are plenty of people who will do well because of [the plans], but I'm most worried about the working class and the middle class" (USA Today, 3/9). Jon Kingsdale, executive director of the Connector board, said, "We want it to get everybody in the Commonwealth using health insurance, but we also want to be humane and recognize the exceptions" (Boston Globe, 3/9).

Criticism
Health care activists have criticized the low-premium basic health coverage plans saying they contain "hidden costs," such as coinsurance and high deductibles, the AP/Boston Herald reports. The Rev. Hurmon Hamilton of the Greater Boston Interfaith Organization said, "The low premiums mask the real costs. There are a significant number of folks who still can't afford those products." He added, "This is movement but it is insufficient." Hamilton said health plans are relying on coinsurance -- where the patient pays a percentage of total health care expenses rather than a set copayment -- to bring down premium costs. Connector officials said the state has consumer protections in place, such as limiting annual out-of-pocket spending, as well as requirements that prevent plans from denying coverage based on pre-existing medical conditions or establishing waiting periods. The Connector board later this month will decide if insurers can offer lower-cost versions of the plans without a prescription drug benefit (AP/Boston Herald, 3/8).

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