Hidden Link

January 29, 2024

By BHAAMATI BORKHETARIA

At the beginning of the pandemic, Congress directed states not to drop anyone from their Medicaid rolls so that people wouldn’t lose coverage in the middle of a health emergency. This led to enormous growth in the insurance program for low-income and disabled residents, with Medicaid rolls nationally ballooning from around 23 million people to 95 million residents.

Once the pandemic ended, Congress instructed states to begin the process of redetermining eligibility for Medicaid coverage, a process that began on April 1, 2023. More than 15 million people have been kicked off of their Medicaid plans nationwide and 400,000 have been removed from MassHealth, the Massachusetts Medicaid program. 

As that process has unfolded, the state has done its best to help residents maintain health care coverage one way or another, said Mike Levine, assistant secretary of MassHealth. 

“Universal coverage in Massachusetts is the North Star, and that has two implications for how we go about this process,” Levine said on a new Health or Consequences episode of The Codcast, with Paul Hattis of the Lown Institute and John McDonough of Harvard’s Chan School of Public Health. “The first is doing everything we can to ensure that eligible MassHealth members stay on the program and don't get tripped up over some of the paperwork concerns. The second piece is around helping those hundreds of thousands of people who we know are no longer eligible for MassHealth [stay covered].”

According to Levine, some of the 2.4 million people who were on MassHealth at the pandemic-related peak are simply no longer eligible for Medicaid. However, for the people who are eligible, he said MassHealth is being proactive in helping them preserve their Medicaid coverage.

For one, the agency has instituted auto-renewal for an increased number of recipients. Levine said the agency has significantly expanded the number and type of recipients who can keep their coverage without going through the renewal process. 

There is also an increased focus on proactively contacting recipients.

MassHealth has “done far more direct member outreach than we ever have before the pandemic,” said Levine. “We are calling members, we are texting members, we are emailing them when they need to take action.”

Members of MassHealth often get health care from Medicaid managed care providers, a network of primary care and specialist clinicians who collaborate to provide care for patients. MassHealth is trying to share information with these providers and encourage them to alert their patients about what they need to do in order to retain coverage.

Levine said that MassHealth is going to continue doing all of those things even after they are done with redetermination. 

For the people who have become ineligible for Medicaid, MassHealth automatically directs them to the Health Connector– a state-based marketplace for health insurance coverage – in order to help them stay covered and access any subsidies that they might still be eligible for. 

Levine said that over 50,000 new members have received coverage through the Health Connector, an indication that people previously on MassHealth might be finding affordable coverage elsewhere.

Nearly a year into the redetermination process, Levine said that he is happy with Massachusetts’s approach. “I'd say we feel, we feel good about the steps we've been able to take around preserving coverage for many of our populations,” he said.