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Massachusetts health care — wonky, with a healthy dose of reality

The ACA Is Good For Massachusetts - Coverage Simplification Edition

The ACA Is Good For Massachusetts - Coverage Simplification Edition

April 3, 2014

The Blue Cross Foundation today issued an update to their essential chartpack, MassHealth: The Basics - Facts, Trends and National Context.

The charts are prepared by the Center for Health Law and Economics at the UMass Medical School, and put MassHealth, our Medicaid program, in the context of who gets helped, what it costs, and how people get coverage. The Foundation has been issuing these periodically since 2008, and they are the definitive source of background on MassHealth.The latest one includes charts showing that

  • MassHealth covers a third of all births in the state, and cares for more than half of people with disabilities, more than half of children of low-income families, and two-thirds of residents of nursing facilities;
  • nearly two-thirds of the program's spending is for the care of members with disabilities and for seniors.
  • the main driver of MassHealth spending growth in recent years has been the increase in MassHealth members, not the amount spent for each member. Per capita spending has grown by an average of just 1 percent per year in the past 5 years, much less than private insurance.
  • MassHealth has been providing more care in community-based settings and less in facilities and inpatient settings. Over the past six years, spending on nursing facility and hospital inpatient care declined slightly while a substantial portion of growth in spending was due to increased spending on community based long term support services.
  • Massachusetts is in the middle of the pack among states in the percent of residents covered by Medicaid.

But what caught this wonk's eye is the chart showing who gets which type of MassHealth and other subsidized coverage, based on age, family and disability status, and other factors. Because of the ACA, the state is able to dramatically simplify the various flavors of MassHealth coverage.

Here's the old version, pre 2014 (slide 6 from this presentation):


Susidized coverage chart before 2014


And here's the new version (slide 5), as of 2014 and the ACA:


The current version is much simpler for members to understand, for providers to work with, and for the state to administer. This is what progress looks like.

   -Brian Rosman