Massachusetts: Good news: 500% ConnectorCare Pilot extended another year!

Two years ago the Massachusetts Health Connector sent out the following memo:

Pilot expansion of ConnectorCare reshapes affordability and plan options through the Health Connector

• This historic expansion allows for more access to health insurance plan choices that are both affordable and better suited to meeting an individual’s health needs

BOSTON – Today, the Massachusetts Health Connector Board of Directors approved regulatory changes that will expand access to the Marketplace’s landmark ConnectorCare program through a two-year pilot program, creating the opportunity for tens of thousands of people to access more affordable health care. The ConnectorCare program is currently available for people who make up to 300 percent of the Federal Poverty Level (FPL) and do not have access to health coverage, such as through an employer.

Massachusetts' ConnectorCare program still involves enrollees signing up for private ACA exchange healthcare plans, but provides additional financial assistance (including no deductibles). You can only enroll in a ConnectorCare plan if you're financially eligible to do so.

The regulatory changes were required after Governor Maura Healey signed the Fiscal Year 2024 state budget last week, which included expanding the income limits of ConnectorCare from 300 percent of the Federal Poverty Level to 500 percent and all Marketplace carriers to participate in the program for the first time. Together, the changes mean more residents than ever before will qualify for more help lowering health care costs since the creation of the Health Connector in 2006 and will also have greater access to more plan options.

As I noted at the time, this was a huge expansion of the program. For comparison, the Basic Health Plan (BHP) programs in Minnesota, New York, Oregon and (soon) DC only run through 200% FPL (the NY program has been extended up to 250% FPL but is being forced to revert back to the 200% cut-off).

...The ConnectorCare program started in 2014 to deliver Affordable Care Act benefits to Massachusetts residents, replacing the Commonwealth Care program launched with the Health Connector’s creation in 2006. Using federal Advance Premium Tax Credits and additional state funding, ConnectorCare provides help paying for premiums and co-pays on a scale based by income. It also includes no deductible payments for members.

...The changes will provide cost savings to more than 50,000 people. This includes current Health Connector members who earn between 300 and 500 percent of the Federal Poverty Level, as well as people who are transitioning from MassHealth, have applied for Health Connector plans in the past and did not qualify for subsidy, or are new applicants.

The expaned ConnectorCare has been quite successful for the past two years, with over 50,000 additional Bay Staters (66,000 according to the official CMS 2025 Open Enrollment Public Use File) being added to the program. However, it was supposed to only last for two years.

Thankfully (especially given the pending expiration of the enhanced federal tax credits), it looks like it's been extended for a third year:

Section 114 Health Connector 500% FPL Connector Care Pilot Extension 3

Section 114 of said chapter 28 of the acts of 2023 is hereby amended by striking out the figure "2026" and inserting in place thereof the following figure:- 2027.

This section, together with related sections, extends the two-year 500% FPL Connector Care pilot for one additional year.

This is also referenced in the 2026 Seal of Approval Submission Summary memo sent to the MA Health Connector Board of Directors on July 9, 2025:

Rate Filings It should be noted that rate filings for the merged market yielded a weighted average increase of 13.4%, the highest seen in many years. These rates assumed that both enhanced APTCs and the ConnectorCare Pilot would expire at the end of 2025. As the ConnectorCare Pilot was extended for one year in the FY2026 budget recently signed by the Governor, carriers may request to adjust rate filings to reflect the change, and staff anticipate it would result in downward adjustments. The DOI is currently going through an extensive review of the filed rates for 2026.

I should caution, however, that I also found this article at ClearFile Solutions, a SaaS vendor which I presume works with the MA Connector; it includes the following warning:

ConnectorCare, Massachusetts’ signature affordability program, is about to face its first real stress test. For the first time in a decade, federal policy changes threaten to strip away subsidies for tens of thousands of members — and carriers will have to decide whether to adapt or retreat.

By “wrapping” state-funded subsidies around federal ACA Premium Tax Credits (PTCs), the Commonwealth has extended low- or no-premium plans with minimal copays to residents who otherwise would have been priced out of coverage. As of mid-2025, ConnectorCare covers more than 319,000 members — the highest enrollment in the program’s history. But that success depends entirely on the federal framework.

...On July 4, the federal budget reconciliation bill changed the rules for PTC eligibility. The result:

A definite loss of coverage for ~33,000 members under 100% FPL

This group represents roughly 33,000 ConnectorCare members. They are largely lawful immigrants — including green card holders, certain humanitarian statuses, and other legally present residents — many caught in Medicaid’s “five-year bar” that delays eligibility for full-scope Medicaid.

They’ve relied on a unique ACA policy exception allowing PTC eligibility even below 100% FPL. ConnectorCare wrapped state subsidies around those PTCs to bring premiums to $0 or near-zero.

Under the new law, PTC eligibility for anyone under 100% FPL is revoked, regardless of immigration status. Without that federal base subsidy, ConnectorCare has nothing to wrap around. Without subsidies, a benchmark silver plan could cost $400–$500 per month, a significant share of income for households at the federal poverty level.

A potential loss of coverage for ~19,000 members between 400–500% FPL

These 19,000 members joined through the ConnectorCare expansion pilot, made possible by enhanced PTCs (ePTCs) from the American Rescue Plan Act and extended by the Inflation Reduction Act.

Those enhancements expire at the end of 2025 unless Congress acts. Without them, members above 400% FPL lose federal PTCs — and ConnectorCare eligibility — overnight. For a family of four in this bracket, losing ConnectorCare could mean going from $150/month premiums to $900/month or more.

I admit that this confuses me a bit: Gov. Healey signed the 2026 Budget Recommendation, which includes the 1-year ConnectorCare extension, on July 4th (yes, Independence Day, and also the same day that Donald Trump signed the Big Ugly Budget Bill into law. Surely both she as well as the MA legislature knew at that point that the enhanced federal subsidies were almost certain to expire at the end of 2025; I have to imagine that they accounted for this when deciding to keep the pilot program running for a third year.

On the other hand, it's possible that they're going to use the savings from the 33,000 low-income immigrant enrollees who are definitely no longer eligible for the program to cover the extra cost of covering the 19,000 enrollees who earn between 400 - 500% FPL instead? That'd be a bit depressing but it's still better than having to kick that population off of the program as well.

My best interpretation of this is that the ~46,000 enrollees who earn 300 - 400% FPL should be safe while the additional ~19,000 who earn 400 - 500% FPL will have their ConnectorCare status in limbo next year.