Children’s Health and Wellness Bill Becomes Law
Massachusetts continues to lead in children’s access to health care, however, many children and families continue to face barriers to coverage and care. Families, advocates, and policymakers recognize the need for additional improvements to ensure that all residents of the Commonwealth – particularly children and youth – can access the care they need. With this concern in mind, on July 29th Massachusetts Speaker Robert DeLeo introduced a bill known as An Act relative to children’s health and wellness (H. 4012). The bill included several policy proposals, two of which are Children’s Health Access Coalition (CHAC) priorities: ensuring continuous MassHealth coverage for former foster youth and requiring the Health Policy Commission (HPC) to study access to care for children with medical complexity, as well as a Health Care For All (HCFA) and Children’s Mental Health Campaign (CMHC) priority: improving the accuracy of provider directories, which the Senate had previously passed as stand-alone legislation this spring (S. 2295).
The Senate then introduced and passed their version of the legislation that included some variations on the provisions included in the House bill, along with several additional provisions related to the Department of Children and Families and other issues (S. 2368). A Conference Committee quickly worked out the differences and by November 20th, the legislature enacted the new version of the bill, H. 4210. Governor Baker signed the final version of An Act relative to children’s health and wellness on November 26th, making it a law in Massachusetts – Chapter 124 of the Acts of 2019.
This new law will have a positive impact on children, families, and individuals in communities across Massachusetts. Chapter 124 includes provisions similar to legislation filed by Representative Barber and Senator Lewis (H. 913/S. 610) to improve the accuracy of health insurance provider directories. Families and individuals seeking care in Massachusetts often face difficulties finding providers through their health plan’s provider directory because insurers may not regularly update their provider directories. As a result, insurance carriers appear to have adequate networks, however, upon closer inspection, a number of listed providers have moved, closed their practice, or no longer participate in a given plan – “ghost networks.” Even for providers who are still practicing and in-network, the provider directory often contains inaccurate information about the services they deliver, languages providers speak, and whether or not the provider is accepting new patients. These issues are particularly acute for families seeking behavioral health care. Chapter 124 would make short-term improvements to provider directories, including ensuring that provider directories are easily searchable, available to the public, and updated at least monthly, as well as establish a taskforce, chaired by the Division of Insurance, to make recommendations and develop regulations to make further improvements to provider directories. These provisions reflect the language agreed upon by advocates, health insurance carriers, and providers.
For some populations, the bill already had an impact even before being enacted by the legislature and signed into law. The Affordable Care Act included a provision to require states to provide Medicaid coverage to former foster youth until the age of 26, given that they were in foster care as of the age of 18, just like other young adults who are allowed to remain on their parent’s insurance until that age. However, given extensive challenges and the transient nature of former foster youth, many young adults who had “aged out” of care through the Department of Children and Families lost their MassHealth coverage for a period of time. Eligibility redetermination paperwork is sent to their last known address, at which these young adults may no longer reside causing delays or loss of coverage. If received, much of the form required them to fill out information on their income, despite being eligible for coverage under federal law regardless of income. The language included in Chapter 124 was based on legislative filed by Representative Gregoire and Senator DiDomenico requiring MassHealth to create a simplified redetermination process for former foster youth (H. 124/S. 35). In addition to the legislature, advocates are working with MassHealth to take steps to ensure uninterrupted coverage for former foster youth. Former foster youth between the ages of 18 and 26 will find it easier to maintain their MassHealth coverage by the end of 2019, due to a new system staff and leadership at MassHealth is putting into place to ensure continuous coverage for this population. The new system will protect MassHealth coverage for this population until their 26th birthday without the need to complete redetermination paperwork. This is a big step forward for former foster youth and again puts Massachusetts on the map as a leader in access to health coverage.
Children with medical complexities (CMC) are also among those who will be positively affected by the Children’s Health and Wellness law. CMC is defined as a population of children who have at least one chronic condition which require high health care needs and can include mental health diagnoses. Families raising CMC often interact with complex systems that are uncoordinated, inconsistent, and difficult to navigate. Current health care, school, state agency, and community-based systems may not be well equipped to support these children and families. Comprehensive data about this population would allow for a greater understanding of the gaps in care. The language included in Chapter 124 is based on stand-alone legislation (H. 1141/S. 680), filed by Representative Cronin and Senator DiDomenico, to require the HPC to conduct a study on CMC to advance an understanding among stakeholders and policymakers to inform potential policy and systems solutions.
We appreciate the work of legislative leaders and our partners in the children’s health advocacy community in taking this next step towards improving access to care for children in Massachusetts. HCFA will continue to work with stakeholders to further increase access to comprehensive, quality and affordable health coverage and care for children and families across the Commonwealth.
- Noemi Uribe, Policy & Project Coordinator, Health Care For All