Two major positive developments in Massachusetts health policy yesterday:
First, the legislature approved a supplemental appropriations bill (pdf) that includes $20 million in funds for the Commonwealth Care Bridge program. Without the funds, coverage would have ended on January 31. These funds should be sufficient to allow the program to operate through June, the end of the fiscal year.
The Bridge program covers around 22,000 legal immigrants who were cut off the regular Commonwealth Care program a year ago. The program has fewer benefits and higher copays than Commonwealth Care, as well as a more limited network of providers under the CeltiCare Health Plan. The Supreme Judicial Court is currently considering a lawsuit brought by HCFA-affiliate Health Law Advocates challenging the constitutionality of providing fewer benefits to some legal immigrants on the basis of their immigration status.
The supplemental appropriations bill also includes $258 million in additional MassHealth funds, including almost $50 million for the Children's Behavioral Health Initiative. This funding will allow the state to access an additional $157 million in federal reimbursements, which will support our economy and reduce the burden on the state budget. A number of public health programs also received additional funds, including $2.5 million for early intervention services for children with developmental delays or disabilities, and funds for domestic violence and sexual assault prevention, substance abuse, and suicide prevention.
Second, the Rate Review Board that is charged with setting the employer assessment that funds the Medical Security Program (MSP) met yesterday and agreed to increase the annual assessment by $16.80 per employee. The MSP statute requires the assessment to be increased whenever the current rate is determined to be inadequate to fund the program. The program anticipates a $95 million deficit, forcing the assessment increase.
The MSP program provides a lifeline to low-income workers who lose their job through no fault of their own and are on unemployment insurance. The deep recession has dramatically increased the number of people covered under the program:
Source: Division of Health Care Finance and Policy Quarterly Indicators
The assessment was originally set at $16.80 per worker annually in 1988, and was never increased for 20 years, until it was raised last year to $33.60. The increase to $50.40 approved yesterday means the assessment is still below what it would be had it kept up with the medical inflation since 1988 (which would equal around $56.41 in 2010). The fund also received a $30 million appropriation last year, and drastic cuts were made to the program's benefits. Much of the funding problem stems from the fact that almost $200 million was diverted from the fund in 2001 and 2003.
We are very grateful that the Administration and legislature acted to keep the Bridge and MSP programs operating. Both programs are in need of overhaul, and the advent of national reform through the Affordable Care Act in 2014 will allow for changes in both of these programs. For those who depend on the critical health benefits these program provide, New Year's 2011 just got a bit happier.