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A Waiting List Is Born -- MassHealth Essential Closes the Door

A Waiting List Is Born -- MassHealth Essential Closes the Door

May 30, 2005

This week will mark the official closing of eligibility for the part of MassHealth known as MassHealth Essential, which will reach its statutory enrollment cap of about 43,000 poor, long term unemployed individuals. The State will begin collecting names on a waiting list instead of opening the door to medically necessary services for a desperately low income and vulnerable population.

A little history: this program was originally called MassHealth Basic and began in the state's major health reform period commencing in 1997. During the 2002 fiscal crisis, House Speaker Tom Finneran demanded and won the elimination of the program and coverage for 36,000 in the program. In the spring of 2003, Sen. Pres. Travaglini and Gov. Romney persuaded Finneran to accept a new program, with tighter eligibility and even less benefits, called MassHealth Essential to serve this population. Trav and Romney understood the state stood to lose hundreds of millions in federal dollars by not reinstating the program and convinced Finneran on that score. MassHealth Essential opened its doors on October 1, 2003, and re-enrollment at first was slow. It has since picked up and is now reaching its enrollment cap.

By the way, MH Essential is managed by the Mass. Behavioral Health Partnership which does an outstanding job managing all medical services for this needy population. Anyone eligible for Essential and put on the waiting list will still be eligible for the Free Care Pool. So they can use hospital emergency rooms, but may not get primary care.

Last year, Gov. Romney -- as part of his health reform initiative -- said he wanted to enroll about 106,000 persons who are "eligible and unenrolled" in MassHealth. His own administration estimates that at least 24,000 of those 106,000 would come in under Essential. Yet his House 1 budget proposal in January capped Essential's enrollment at existing levels. The House also disappointed in its budget plan, keeping the Governor's cap, and rejecting Rep. Deborah Blumer's amendment to expand. The Senate budget plan would increase Essential's enrollment cap by about 10,000 -- not enough, but a good step forward. Thank you, Senate!

Just like last year, when the Children's Medical Security Plan started a waiting list that totalled 15,000 kids by July, 2004, we're starting a MassHealth Essential Waiting List watch, and we'll let you know as it grows and grows.

Meanwhile, if you would like to help, please contact your Senator and Rep and ask them to support the Senate's higher enrollment cap for MassHealth Essential. Yeah, it's only about 10,000 out of 530,000 uninsured persons in Massachusetts. But it's something YOU can do TODAY that will make a difference in the lives of 10,000 very low income uninsured persons. So how about it?