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Model Massachusetts ConnectorCare (state premium + cost-sharing wrap) #9223

Description

@DTrim99

Program

ConnectorCare (Massachusetts Health Connector) is a long-standing state program that layers a premium wrap plus a cost-sharing wrap on top of the federal APTC/CSR so that enrollees hit a state affordability schedule (percent-of-income premium caps by plan type).

Eligible population / income range

  • Core: at or below 300% FPL.
  • 300–500% FPL pilot extended through 2026, but Plan Type 3D (400–500% FPL) was dropped for 2026; Plan Type 3C (300–400% FPL) remains.

Benefit design

State premium wrap on top of APTC to reach the state affordability schedule (percent-of-income premium caps that vary by ConnectorCare plan type), plus a state cost-sharing wrap.

PY2026 status

Active, long-standing; the above-400% pilot is winding down for 2026. ~200k+ enrollees. Parameter end-dates matter (300–400% pilot tier through 2026).

Modelability

Medium per the survey — a percent-of-income schedule that needs benchmark-premium data, using the same machinery as the federal PTC, plus a plan-type structure.

Reference implementation pattern

The Maryland Premium Assistance pattern (issue #9217 / PR #9218) — a state target-percentage schedule vs gov.aca.required_contribution_percentage, the SLCSP gap, and a post-APTC cap — is directly applicable to the ConnectorCare premium wrap (percent-of-income schedule). The cost-sharing wrap is an additional component.

Sources

  • mahealthconnector.org
  • acasignups.net (MA 300–500% pilot detail)
  • KFF, "State-Based Efforts Will Provide Limited Relief..." (kff.org)

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    aca-subsidyAffordable Care Act subsidyenhancementNew feature or requestmedicaidMedicaid and related health programsstates/maMassachusetts

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