State health plan chief urges higher rates

Most lower-income Massachusetts residents without health insurance would be expected to pay more for coverage than originally proposed, under a recommendation by the official overseeing implementation of the state's health insurance law.

The Commonwealth Health Insurance Connector, a new agency that will help set insurance premiums for plans to be offered to the uninsured, expects to approve rates today for residents with incomes between 100 and 300 percent of the federal poverty level, the latter of which is $29,412 for a single person.

Jon Kingsdale, executive director of the Connector, will recommend that single adults pay $18 to $106 a month, or 1.76 to 4.7 percent of their income, depending on their annual earnings. Families would pay more. A couple with one child, for example, would pay $36 to $240 a month, or 2.1 to 6.3 percent of their income, including a contribution to the state-federal Medicaid program for coverage of their child.

Two weeks ago, a subcommittee of the Connector recommended lower payments. The panel wanted single adults to pay $10 to $100 a month, or 1 to 4.5 percent of their income. The subcommittee recommended that couples pay $20 to $200 a month, or 1.5 to 6.6 percent of their income.

But Thomas Trimarco, Governor Romney's secretary of administration and finance and chairman of the Connector board, argued that those amounts were too low, particularly at the lower end of the income scale. Kingsdale subsequently developed new recommendations, explaining in a memo to board members that the contributions generally are below what workers typically pay for health insurance. Kingsdale also said the fees could not be so low as to encourage employees who currently have insurance through their employer to abandon that coverage in favor of a state-subsidized plan.

Advocates for the uninsured, who were lobbying for far lower contributions for low-income workers, were critical of the new proposal.

``We think they're too high," said John McDonough, executive director of Health Care for All, an advocacy group in Boston. ``We expect with this level of premium contribution that the plans will not meet their enrollment targets."

The insurance law requires that all Massachusetts residents have coverage by July 1, 2007, or face tax penalties. But individuals can be exempted if they show they cannot afford coverage.

Liz Kowalczyk can be reached at kowalczyk@globe.com.