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

New Required Reading: MassHealth Facts, Trends and National Context

New Required Reading: MassHealth Facts, Trends and National Context

November 1, 2011

This morning, the Massachusetts Medicaid Policy Institute (MMPI) released an updated version of its essential guide, MassHealth: The Basics (pdf), prepared by the UMass Medical Center for Health Law and Economics.  In addition to an overview of MassHealth program and enrollment trends, this version includes a lot more colorful charts and perspective on how MassHealth measures up against other state Medicaid programs.

Key takeaways:

  • With 1.3 million members, MassHealth is critical to many Massachusetts residents.  More than half of people with disabilities, more than half of children of low-income families, and two-thirds of nursing home residents rely on MassHealth to help them pay for health care.  In addition, one-third of all births in the state are covered by MassHealth.
  • MassHealth offers eligibility to a broader segment of the Massachusetts population than many other states’ Medicaid programs.  However, this does not mean that MassHealth covers an unusually high portion of the Massachusetts population when compared to other states, because of the high rate of employer-sponsored insurance and higher incomes in Massachusetts.
  • The biggest driver of MassHealth spending in recent years has been the jump in MassHealth members due to the recession, not the amount spent for each member. MassHealth is countercyclical, playing an important role in supporting people who are affected by economic downturns.  In addition, MassHealth spending per capita has grown more slowly than private health insurance premiums.
  • MassHealth spending trends reflect policy toward providing more care in community-based settings and less in facilities and inpatient settings. In the past three fiscal years, spending on nursing facility and hospital inpatient care declined slightly while a substantial portion of growth in spending was attributable to increased spending on community based long term support services.

Indeed, MassHealth is a central part of the Massachusetts health care safety net.  Without this program, 1.3 million Massachusetts residents would have no other source of affordable health insurance.

This should be required reading for every state legislator, and all of us who want to understand the biggest program in state government. Thanks to MMPI for the great work.
-Suzanne Curry