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

Senate Budget Makes Further Progress

Senate Budget Makes Further Progress

May 16, 2006

Today the Senate Ways and Means Committee release their budget proposal for fiscal year 2007 (which starts July 1, 2006).

Health advocates were pleased that the budget fully funds the health reform initiatives and includes a number of other important provisions. A summary of the budget from the Committee as well as the language of the line items and outside sections are online here. The Mass Budget and Policy Center issued their preliminary analysis this afternoon.

The full Senate will consider the budget starting next Wednesday. Amendments are due by this Friday.

Health Reform Funding Included

The Senate budget integrates the MassHealth expansions included in the health reform statute into the various line items. Included in the recommendations are

* $18.2 million to increase MassHealth eligibility for children in families with incomes up to 300 percent of the federal poverty level;
* $42.1 million to restore benefits to over 500,000 adult MassHealth members, including dental coverage, dentures and eyeglasses;
* $7 million for a MassHealth smoking cessation pilot program;
* $10 million increase for the Insurance Partnership program, which provides subsidies to small businesses for health insurance costs;
* $77 million increase to the MassHealth Essential program, to clear the waiting list and enroll up to 17,000 more eligible members;
* $5.2 million increase to the CommonHealth and MassHealth HIV programs in order to avoid enrollment caps;

The bill also transfers funds to the Commonwealth Care Trust Fund to support the provisions of the health reform law, including the new low-income subsidy program called the Commonwealth Care Health Insurance Program.

Foster Children’s Coverage Expanded
The proposal includes $1.5 million to expand MassHealth coverage to approximately 600 young-adults aging out of the state’s foster care system. Similar language was included in the House budget. Currently, foster children lose all health coverage when they leave foster care as they turn 19. Both the House and Senate bills allow eligible foster children to retain their coverage for an additional year. This has been a major goal of the Children’s Health Access Coalition and we are pleased that this provision should be in the final budget sent to the Governor.

Prescription Drug Assistance

The Senate Ways and Means budget did not include language to extend or amend Chapter 175 of the Acts of 2005, the state safety net for MassHealth and Prescription Advantage members who were transitioned to Medicare drug coverage on January 1. This safety net, which is being used by 200 people every day to get their medications, is currently set to expire on June 30th. Senator Montigny will file an amendment to extend this vital protection, which expires June 30.

The Prescription Advantage line item did include language providing another open enrollment period in the Fall of 2007 and keeping cost sharing level for Prescription Advantage members through FY 07. They also included sufficient funding to pay for the open enrollment period.

Citizenship Verification Assistance Included
Starting July 1, a new federal law will require citizens applying for MassHealth or renewing their eligibility to show proof of citizenship. This cumbersome requirement will require nearly a million MassHealth members to either produce a birth certificate or passport, or lose the vital health coverage to which they are entitled. In addition to the difficulty involved in gathering the documents, there can be considerable expense charged to get official certified copies.

MassHealth officials have said they will try to implement this federal requirement in the least intrusive manner, and they are waiting for more guidance from federal officials before finalizing their regulations. Note that this provision is not aimed at undocumented immigrants, who are barred from all but emergency Medicaid by federal law. Rather, the burden falls entirely on citizens.

The Senate budget includes several provisions to make it easier for MassHealth members to comply with this requirement. One provision directs EOHHS to assist applicants and recipients in obtaining the required verification at no cost to the applicants and recipients. Another provision directs DPH to waive all fees for anyone requesting a copy of a birth certificate for the purpose of establishing eligibility for Medicaid.

Other Provisions
Also included is a $14 million increase to the Uncompensated Care Pool, and language prohibiting the state from taking advantage of new federal loosening of Medicaid restrictions by reducing benefits or increasing cost-sharing for members.