A Healthy Blog

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

Untangling Medicaid Myths

Untangling Medicaid Myths

November 11, 2011

Untangling Medicaid Myths headline

It's a hard job, but someone's got to do it: "clear away some of the misconceptions that muddy the debate about the future of Medicaid." That best someones in the state to do it are Kate Nordahl, director of the Mass Medicaid Policy Institute and Sarah Iselin of the Blue Cross Blue Shield of Massachusetts Foundation.

In their Boston.com The Podium blog post, they puncture the many myths that are too prevalent in discussions about MassHealth, our Medicaid program. Nordahl and Iselin emphasize that:

  • MassHealth is the essential health safety net for more than 1.3 million Bay Staters. Though adults and children with disabilities comprise 20 percent of MassHealth members, and seniors make up another 11 percent, nearly two-thirds of the program's spending is for the care of members with disabilities and for seniors. More than half of all people with disabilities and two-thirds of nursing home residents rely on MassHealth.
  • Beyond its safety net role, MassHealth benefits help make employer-offered health insurance more affordable for eligible low-wage workers and their children by paying the employee share of the premium and by covering most of the cost of copayments and deductibles. In addition, MassHealth benefits make it possible for many people with disabilities to remain in the workforce.
  • MassHealth is cost effective. Spending has increased at a slower pace than premiums in the private sector. The amount MassHealth spends for each member's coverage rose by 1.6 percent in 2010, while individual premiums for employer sponsored health insurance in Massachusetts grew by an average of 8.4 percent. The biggest driver of MassHealth spending growth in recent years has been the increase in members due to the recession, not the amount spent for each member.

The post concludes with an important policy message:

Policymakers, including the “super committee,” are certainly justified in looking for ways to make Medicaid more efficient and effective, but they would do well to draw upon the lessons from states where it is working well. As our research demonstrates, the Massachusetts version of Medicaid – MassHealth – is the financial backbone of the state's nearly universal coverage and provides an essential health safety net for people who are most affected by high unemployment, declining incomes, and the nation's relentless increase in health care costs.

-Brian Rosman