More costs – for the individuals who can least afford it – are creeping into the Massachusetts mandatory health insurance plan.

If rules proposed this week are approved, premiums for subsidized insurance plans would go up 14%, some co-pays would double, deductibles would increase and the out of pocket cap for some drug costs would disappear. The proposal would pass on increasing costs to people making just 100-300% of the federal poverty level. It comes in the wake of revelations that the cost of subsidized care in Massachusetts will be double original projections – $1.35 billion – by 2011.

Also discussed by the board implementing the Massachusetts law this week were premium increases for the state’s unsubsidized insurance plans and a new scale to measure "affordability" of insurance plans. Rate increases for unsubsidized plans may be held to between 2 and 10% next year. To do it, consumers will pay higher office or hospital co-pays, higher drug co-pays or deductibles.

"Affordability" standards are also going up. The upper limit for an “affordable” insurance premium (not including co-pays and deductibles) this year was 10% of a
couple’s income. That amount has increased, to a high of 10.6%, or $6,625 of the
income of a couple making $62,500 a year. (See the Connector website for meeting documents.)