MassHealth, Affordability

The economic downturn shaped a lot of our discussion – how it affects clients, state services, and our own organizations. For example, more clients find themselves in tears during appointments – some with problems like home foreclosure that outreach workers just can’t help fix. Many HAN organizations are taking on additional responsibilities with fewer staff. CP has also cut back staffing; we are now closed on Wednesdays.

This summer, MassHealth starting enforcing the rule that households who hadn’t paid their premium bills for 60 days or more would lose their MassHealth or Children’s Medical Security Program (CMSP) coverage. Members of these households may be starting to show up at hospitals and health centers, they may have no coverage, and they can’t get the Health Safety Net.

"Outreach & enrollment" means much more than putting up posters and helping people fill out MassHealth applications. Recently, over the course of a two hour appointment, my supervisor and I counseled one household on eleven different public health insurance, subsidy and care programs. We helped them file four separate applications to five different insurance programs, putting together a patchwork of care options to cover the hole left by the loss of employer-sponsored insurance.

Starting this week, your clients who use the Health Safety Net should look for redetermination letters. Also, verification requests (VC-1s) for people you NEWLY enroll in MassHealth now go to the Central Processing Unit. ...I'm interested to hear how the redeterminations go for people who use the Health Safety Net.

This winter, about 100,000 households in the Commonwealth were protected from losing their heat, electricity and other utilities by the state utility shut-off protection laws, which prevents shut-off for households whose circumstances meet certain conditions. This protection ended on May 1, and people have begun getting shut-off notices. These notices are bad news, but CAN be used to request a MassHealth premium waiver or Commonwealth Care premium waiver.

Our last Boston HAN meeting came in the wake of the Connector Board’s decisions to shift more of the costs of Health Care Reform to consumers by raising co-pays and premiums for Commonwealth Care. Advocates continue to oppose these cost increases and push for sharing the costs more evenly with businesses. Meanwhile, outreach and enrollment workers are seeing an increase in administrative barriers to enrollment in Commonwealth Care and MassHealth.