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

Wonk Alert: Health Reform Trust Fund Primer

Wonk Alert: Health Reform Trust Fund Primer

December 10, 2013

Trust Fund Spending chart

Wonks, start your salivating. This is the real thing. How good is this?:

As noted above, some budgeted funds segregate revenue for a particular purpose, but in most cases this is revenue that would otherwise go into the General Fund. Off-budget funds typically collect revenue from special fees or targeted assessments, and in some cases also receive operating transfers from the General Fund. While these funds are sometimes used to pay for program costs, such as use of the Commonwealth Care Trust Fund for the costs of Commonwealth Care discussed below, they generally do not fund regular operating expenses. Off-budget trust funds may also be used in cases where revenue and the spending it supports do not fit into the annual budget time frame.

Blue Cross Blue Shield Foundation has published its latest budget brief, The Role Of Trust Funds In Masshealth And Health Reform Spending: A Primer (pdf). The short paper is part of series coming from the Mass Budget and Policy Center, Mass Law Reform Institute, and the Foundation's Mass Medicaid Policy Institute.

This paper is useful summary of what has been insider budget trivia, but is actually critical to understanding how Massachusetts pays for health programs. The use of trust funds changes every year, and we hope this paper becomes an annual exercise. -Brian Rosman