MA H1246

Creates a new public health insurance option administered by the Commonwealth Connector Authority, available exclusively through the Health Connector marketplace alongside private plans

Available to eligible individuals (Massachusetts residents not offered subsidized employer coverage from companies with 50+ employees), small groups (1-50 employees) by January 1, 2027, and large groups (51+ employees) by July 1, 2027

Provider payment rates based on Medicare Parts A and B, with all Medicare-participating providers automatically included unless they opt out through an annual enrollment process

Establishes a Public Health Insurance Option Trust Fund to finance plan operations, with premiums set to fully cover health benefits and administrative costs

Authorizes the Commissioner of Insurance to implement risk adjustment assessments among health plans based on enrollee actuarial risk, exempting self-insured ERISA plans