A state board yesterday updated standards that will be used to decide who faces fines this year for failing to have health insurance.
The vote occurred on the same day officials and community members gathered to celebrate the second anniversary of the healthcare law that has resulted in more than 340,000 people getting insurance so far.
"This is a wonderful, wonderful experiment, and it is showing great results," Governor Deval Patrick said at a State House ceremony. "But nothing this ambitious or important comes easy."
To sustain the initiative, Patrick said, the state must reduce expenses.
"Our first priority," he said, "is to rein in costs."
The state faces a rapidly rising bill to cover insurance subsidies and is searching for ways to reduce expenses and raise revenues.
The first person to receive insurance through the subsidized program, Madelyn Rhenisch of Brighton, told those at the ceremony that the bill is well worth it, because it has given her and others security and hope.
Meanwhile, officials are stepping up advertising to encourage the hundreds of thousands of people who are still uninsured to obtain coverage. Those who don't will face a penalty of up to $912 if they are uninsured for the entire year and if the state deems insurance affordable for them.
The Commonwealth Health Insurance Connector yesterday approved new affordability rules that increase the monthly premium considered affordable about 10 percent from 2007 levels. Insurance premiums have been increasing at about that rate statewide, although the connector was able to negotiate an average increase of about 5 percent for the nonsubsidized plans it offers the public.
The rules set out a sliding scale, based on income and family size, that indicates whether the state considers premiums affordable. For example, an individual earning more than $52,500 would be considered able to afford insurance regardless of the premium. But someone earning between $37,501 and $42,500 would be required to purchase insurance only if the premium was $220 or less.
The standards become final after a public hearing and a second vote by the connector.
Consumer advocates said yesterday that they believe the standard requires older people with moderate incomes to spend too much. "We are still concerned that the standard is not genuinely affordable," said John McDonough, executive director of Health Care for All.