Health plan subsidies at risk for 130,000 in Massachusetts

By Katie Lannan
State House News Service

More than 130,000 Massachusetts Health Connector members are at risk of losing their insurance subsidies for 2022 unless they each take specific actions, and the agency plans a communication blitz to ensure people take those steps to keep their subsidies in place.

Connector Authority Executive Director Louis Gutierrez told the agency’s board Thursday that the Internal Revenue Service automatically amended more 2020 tax returns than usual, a result of filing changes created by the federal American Rescue Plan Act.

When returns are amended, he said, income data ends up different from the figures that exchanges like the Connector use to verify subsidy eligibility, and affected members lose that eligibility unless they follow a “fairly straightforward” review and update the income information in their accounts.

“We have really been exploring options, because I would very much like a softer landing than counting on every individual of the 130,000 to understand what must be done, so we will bring this back to the board in October, but we are actively looking for a softer landing than simply dropping people,” Gutierrez said.

He said the Connector is “working to see if there may be a federal policy solution to this development that could prevent these individuals from losing the subsidies, but so far there is no guarantee of that.”

Gutierrez said that in a usual year, 20 percent to 25 percent of members lose their subsidy, but that “gradually works its way down to a much lower level” as people update their accounts. For 2022, he said, that starting point is about 60 percent of members.

Describing it as “particularly important” that members keep their subsidy because enhanced support through the American Rescue Plan lasts through 2022, Gutierrez outlined a series of steps the Connector plans to encourage people to verify their income.

The Connector will highlight the issue on its social media accounts and in all public open-enrollment events across the state, he said. The navigators that help people learn about and enroll in health insurance plans will get lists of affected clients so they can reach out directly and help them update income information.

The Connector had originally planned five communications directed to members losing their subsidies, and has added two more in September and December, Gutierrez said.

Board member Nancy Turnbull described the issue as “one of those ironic unintended consequences of a good policy change.”

“It also seems to me that the burden, if there’s no policy fix, can’t just fall on individual states to try to communicate, but that the feds have some responsibility for additional outreach to people,” she said.

Gutierrez said Massachusetts is working with other states that share the same problem — not all states use the same income verification procedures, he said — and is also working with outside experts and the Centers for Medicare and Medicaid Services.

“We have not yet broached the topic of the federal role in communicating, but we will,” he said. “I think that’s an excellent idea.”