December 2018

December 19, 2018

Last Friday, a federal judge in Texas ruled in favor of a lawsuit arguing that the federal individual mandate, and the entire Affordable Care Act (ACA) along with it, is unconstitutional. We are greatly disappointed about this ruling. The decision is misguided and we are hopeful that it will be appealed by a higher court. We have seen firsthand the impact of this life-saving law; this decision is a dangerous step back in the progress we have made towards universal coverage in Massachusetts and across the country. We will join any effort to prevent the ACA from being decimated any further, whether by legislative, administrative, or judicial attacks at the legislative.

We do, however, want to make clear that there is no impact for now. The ACA is still the law of the land. The Texas ruling will likely go to the Supreme Court and the process will take time. We know that the combination of the elimination of the individual mandate at the federal level, the different deadlines for open enrollment periods in some states, and now this ruling have made the current open enrollment period confusing for consumers. Nonetheless, the law is still in the books. In Massachusetts, open enrollment through the Health Connector started on November 1, 2018 and runs through January 23, 2019. People who want coverage beginning January 1, 2019 must apply, select a plan and pay their premium (if there is one) before December 23, 2018. After that, people who seek coverage must apply, select a plan, and pay their premium no later than January 23, 2019 for coverage beginning February 1, 2019.

While the Texas decision does not have an immediate impact on coverage for millions of people across the county, we recognize that it is important to monitor the situation and think about the future potential impact on Massachusetts and beyond. Although Massachusetts was the model for the ACA and we have many protections in state law, the Commonwealth is not shielded from what happens at the federal level. Massachusetts relies on a partnership with the federal government to provide the robust coverage options available to our residents. Regardless of what happens, some state protections will remain law, like the prohibition on denying coverage to people with pre-existing conditions, but federal funding is necessary to keep the subsidized coverage options through MassHealth and the Health Connector intact. If the ACA were to ultimately be deemed unconstitutional, many protections and affordable health coverage options would be in jeopardy, and the Massachusetts uninsurance rate would shoot up, reversing over 12 years of progress.

We must not let the attempted sabotage of the ACA deter consumers. Open enrollment continues in Massachusetts until January 23, 2019. People receiving health insurance, including those who receive premium and cost-sharing subsidies through the Health Connector or coverage through MassHealth will have no interruption in their benefits. Don’t wait! Head to to apply for health insurance, select a plan and pay your premium by January 23, 2019.

To learn more about the ruling and its potential effect on Massachusetts, see this story from the Boston Globe, which features our Associate Director of Policy and Government Relations, Suzanne Curry.


December 11, 2018

On Saturday, November 17th, HCFA hosted a successful health care enrollment and education session at the Waltham Public Library. This effort was part of the Health Connector's Stay Covered Campaign that aims at ensuring that Massachusetts residents utilize the Open Enrollment period to apply for health insurance or change plans.

In October, the HelpLine noticed an uptick in calls from the Waltham area particularly on the Spanish line. We found out that there were no longer any Certified Application Counselors at the Charles River Community Health Center. From the increased call volume, it was clear residents of Waltham would need additional support during Open Enrollment. Because we had not previously worked closely with community leaders in Waltham, we had to lay the groundwork to find a location and get the word out to the appropriate organizations.

Within a few weeks we found a location, met with community organizations, flyered businesses on main streets in Waltham, sent information through the school system, and outreached with Charles River. Due to the fear in immigrant communities about changes to public charge and what that means for health coverage, we wanted to have immigration counselors available at the event. We had immigration counselors from the Irish International Immigration Center and Catholic Charities along with a public benefits lawyer from Health Law Advocates. We had a Certified Application Counselor from Partners Newton-Wellesley Hospital as well as a Navigator from the Fishing Partnership assisting attendees alongside Health Care For All's Certified Application Counselors. A Community-Health Outreach worker from Charles River Community Health was on site for attendees that needed help finding a primary care physician.

As our team of volunteers arrived to set up, a line of folks already awaiting enrollment and immigration services at the Waltham Public Library greeted us. While our counselors put together the final touches in their respective work spaces, we began to welcome the Waltham community. Family by family we listened to needs and proceeded accordingly. The services sought after varied from first time medical insurance coverage, to renewals, and immigration consultations. The room was filled with parents with newborns, children at play, grandparents waiting patiently, and adults chatting with friends who came to the event together seeking to have their questions answered. Over the span of five hours, we saw people come and go, hopeful to be assisted with health care and immigration support.  

We ended up serving 82 households with help getting health coverage. 70% spoke Spanish, 14% spoke Portuguese, 13% primarily spoke English and 3% spoke Haitian Creole.  Of the 82 attendees, 14 households opted to speak with one of the immigration lawyers. 60% were referred by Charles River, 29% heard about the event from a friend or relative, 6% heard from school, 4% heard about the event from the library, and 1% specifically mentioned seeing a flyer.

Many thanks to the Health Connector for their tremendous support and their efforts to get people covered this Open Enrollment season through their #StayCovered Campaign. Thank you to all volunteers and Health Law Advocates, Catholic Charities of Boston, and Irish International Immigrant Center for partnering with HCFA to address questions regarding the impact of the use of benefits for immigrants. Thank you also to The Fishing Partnership Support Services and Partners Health Care for your continuous support and for offering to assist HCFA's HelpLine in enrolling individuals into health insurance at the event.


December 5, 2018

In 2016, the rate of uninsured children in the United States hit an historic low of 4.7 percent. In a report released last week, the Georgetown University Health Policy Institute’s Center for Children and Families finds that number increased to 5 percent in 2017, marking the first rise in the number of uninsured children nationally since comparable data was first collected nearly a decade ago. 

Here in Massachusetts, we boast an uninsured rate significantly lower than the national numbers. Nevertheless, this report gives us pause because it shows that the Commonwealth joined eight other states in experiencing a statistically significant increase in its rate of uninsured children, with the numbers increasing by 0.5% from 15,000 children in 2016 to 22,000 children in 2017. The reasons for this are not clear, but the findings should be a wake-up call to all of us.

Nationally, the report attributes these shifts in large part to “strong national currents” that include the ultimately unsuccessful effort to repeal the Affordable Care Act (ACA) and cap federal Medicaid funding, a Congressional delay that caused a temporary lapse in funding for the Children’s Health Insurance Program (CHIP), and efforts to undermine ACA Marketplaces which includes reducing outreach and enrollment grants as well as shortening the enrollment period. The authors caution that “…there is every reason to believe the decline in coverage is likely to continue and may get worse in 2018.” At the heart of this warning is worry about the recently proposed changes to the federal “public charge” rule which creates new tests on income and use of public benefits for lawfully present immigrants seeking to adjust their immigration status. The report cites a recent study that found that “implementation of the proposed rule could lead to a reduction in Medicaid enrollment of between 2.1 million to 4.9 people and posits the likelihood that children would “make up the majority who are disenrolled.”

At Health Care For All, we know that health insurance coverage is at the foundation of ensuring that children can access the health care services they need to grow, learn and thrive. Massachusetts is doing well, but we must remain vigilant in our efforts to enroll children and families in high-quality, affordable coverage and to protect, improve and expand the coverage that is available.
Our efforts must include active and vocal opposition to the proposed changes to the public charge rule during the public comment period. Join us now by learning more about the proposed changes and submitting your own comment of opposition before December 10th.

-Natalie Litton