After years of incremental changes, the bulk of Obamacare is about to take effect: The law's rules about individual care—including the controversial "individual mandate"—take effect on Oct. 1. But that's old news in Massachusetts, which has had universal healthcare—AKA Romneycare—since 2006. We've had an individual mandate for seven years!
In fact, many resident believe Romneycare and Obamacare are the same thing with different politicians derided in the name. But that's not true; there are several important changes coming to Massachusetts's health insurance market, according to the Mass Health Connector's "Getting Better" website. The connector site was created in 2006 to help Massachusetts residents get insurance under Romneycare.
So what are some of the changes?
More people will be eligible for subsidies
Under Obamacare, the threshold for tax subsidies is 400 percent of the poverty level. That means anyone making $46,000 or less is eligible for some sort of break on premium costs. For families, that number is $94,000. Under Romneycare, the threshold was 300 percent of the poverty line. The less you make in income, the more federal and state subsidies are available.
Commonwealth Care is going away
This plan, which covered folks with very low incomes, will disappear in 2014 as many of those eligible will get MassHealth (Medicaid) coverage under Obamacare. Higher-income residents kicked off of Commonwealth Care can choose new coverage in the heath insurance exchange.
The threshold for MassHealth (Medicaid) is going up
Anyone making less than 133 percent of the federal poverty level. For a family of four, that's $31,000 in total household income. Many residents who had signed up for Commonwealth Care will be eligible for MassHealth. Others can get a different health plan with deep federal and state subsidies.
About those exchanges
The Obamacare exchanges are based on what was done in Massachusetts, so there won't be as many changes to that pool, according to Mass Health Connector.
You'll need to re-enroll for coverage if you got a plan through the Commonwealth Choice program
According to Mass Health Connector's individuals and families FAQ, most coverage provided will not change. But you will need to re-enroll in your healthcare plan (or, if you prefer, select a new one) once Obamacare takes effect.
Small Business tax breaks are going up
Since 2010 Obamacare has been providing small businesses with tax credits for providing coverage. Those credits are set to increase in 2014.
More tools are coming to help small businesses
Romneycare had many tools to help small businesses, and those tools remain or are expanding under Obama, according to theHealth Connector's business FAQ. Businesses can pool together to earn purchasing power when buying health insurance, earn tax credits with wellness programs, find new tools for selecting plans and more. The state's also repealed and simplified some of the previous paperwork businesses had to fill out.
Penalties are going up
Under the new plan, penalties start at 1 percent of income or $95, (whichever is more) in 2014, but balloons to 2.5 percent/$695 in 2016. It continues to increase every year, based on a cost-of-living adjustment. And that penalty is taken out of your federal tax return. There was some concern that the Massachusetts penalty would be piled on top of the federal penalty, but the state legislature made that fix earlier this year.
Business penalties are going up, too
Under Obamacare, businesses with more than 50 employees can get tagged with up to $2,000 per employee in penalties if they do not offer the worker insurance, or offers unaffordable self-only insurance, or offers a substandard plan. That's far more than the $295 per employee penalty under Romneycare. This gets complicated, so it's best for larger business owners to check the Health Connector's business page.
There's someone to call if you have more specific questions
Mass health Connector has more details about the changes on its website. You can also call 1-877-ENROLL Monday-Friday from 8 a.m. to 5 p.m. and speak with someone if you have specific questions.
There's a download for you, too: There are several, actually, from pamphlets about changes for individuals, to booklets containing comprehensive details about ever aspect of Obamacare and what it means for Bay State residents and businesses alike. You can find those documents here.