A Healthy Blog

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

Happy New Section 1115 Medicaid Waiver Day!

Happy New Section 1115 Medicaid Waiver Day!

July 1, 2005

We missed the celebration -- the balloons, banners, band, confetti and the rest celebrating the first day of Massachusetts' new Medicaid waiver. It begins today, July 1, ready or not, and one of the only clear things is that we're NOT ready.

What the heck is the 1115 waiver? Massachusetts, like many states, runs our Medicaid program under special terms negotiated with the US Department of Health and Human Services, giving the state much more flexibility than permitted under standard Medicaid -- and much more money, about $1.3 billion in our case. Massachusetts' first waiver, which ran from 1997 to 2001, allowed the state to expand MassHealth (the name of our Medicaid program) to more than 300,000 lower income persons, driving down our rate of uninsurance to one of the lowest in the nation. The second waiver ran from 2001 until last night at 11:59pm. The new waiver starts today.

Senator Kennedy and Gov. Romney negotiated the broad outlines of an agreement released in February of this year. That deal left many, many vital details unanswered with the expectation those details would be ironed out before 7/1/05. These details have not yet been worked out, leaving the state driving on this expensive highway with blinders. The waiver is also a key component of the RomneyCare health reform proposals.

If you want to know gory details about the Massachusetts waiver, check out this excellent policy report produced in April by the Mass. Medicaid Policy Institute. In the meantime, happy new waiver day to you and yours!</sp