Today the SJC ruled in Provencal, or the slip opinion link that if your employer offers health insurance, and pays at least 33% of it, even if you cannot afford that insurance and would have been eligible by income for a subsidized policy at a far lower, if you don’t get your employer’s policy you get NOTHING and have no recourse.
The reason for this result is that the Connector has not issued any regulations to cover waiver of the ESI (employer policies). This looks like a problem for fast tracked legislation, frankly.
The law of unintended consequences seems to apply together with the draconian obeisance to agency discretion in this state. This issue has been discussed with regard to the Isaac and Jeremy decisions in the field of child welfare law. Similarly, bowing to the discretion of the Department of Children and Families (at that time called “DSS”) the SJC held that it would concede to agency expertise and budgets, and judge’s lost the ability to make decisions in the best interests of children in Juvenile Court over DCF objections, and were reduced to only over turning egregious errors using the abuse of discretion standard.
The reason for calling today’s news on the Massachusetts Health Insurance Front is the declared progress in closing the gap effecting emancipated college students and health insurance per the Governor’s Press Release today
So – a step forward for students, one hopes, but it looks like a step backward for the working class. The Provencals were charged $194.00 every two weeks as their employer paid 33% – but the sole wage earner earns $24k a year so that constitutes over 20% of their after tax and FICA (etc.) income.
Let’s enact specific regs and standards for when ESI can be waived – how about it, Beacon Hill???