Department of Revenue will enforce the insurance requirement by imposing a penalty. In 2007, the penalty was the loss of the personal exemption. Beginning in 2008, the penalty is half the cost of the lowest available yearly premium which will be enforced as an assessed addition to the individual's income tax. Young adult coverage Beginning July 2007, the Connector offered reduced benefit plans for young adults up to age 26 who do not have access to employer-based coverage. Changes to the law In 2008 and 2010, much more substantive changes were made to the law, one of the most important of which was to begin an open enrollment period for those receiving subsidized health insurance and anyone buying insurance, including those paying full price, as an individual. Prior to that 2010 change, under the Massachusetts law, residents buying healthcare insurance individually could do so at any time, even—theoretically—as being admitted to a hospital or entering an emergency room. This led to a gaming of the system and research by the state said this gaming added 1–2% to premium costs, which were continuing to rise for other reasons as well. Given the continuing overall rise in premiums post Massachusetts 2006 healthcare insurance reform, the major goal of the 2012 amendment was to introduce price controls on health care itself; it is not directly related to healthcare insurance as are the earlier legislative actions. Starting in 2014, Commonwealth Care insurance (and Commonwealth Choice insurance for those not receiving subsidies) has been replaced by insurance compatible with the federal Patient Protection and Affordable Care Act. Among other differences, consistent with PPACA, the out of pocket spending limits and deductibles are higher under similarly priced (after a PPACA tax credit) PPACA-consistent insurance than the superseded Massachusetts insurance law. To try to compensate for these higher limits and deductibles, the Commonwealth funded an additional insurance program called Connectorcare, by which residents who previously would have qualified for Commonwealth Care can get very similar benefits for about the same price. Implementation The implementation of healthcare insurance reform began in June 2006, with the appointment of members of the Connector board and the naming of Jon Kingsdale, a Tufts Health Plan official, as executive director of the Connector. On July 1, MassHealth began covering dental care and other benefits, and began enrolling children between 200% and 300% of the poverty level. The federal Centers for Medicare and