Medicaid redetermination process off to fast start
9,000 shifted from MassHealth to Connector since April
A TOP STATE OFFICIAL says 9,000 residents have transferred from MassHealth to the Massachusetts Health Connector since April as part of the post-COVID Medicaid redetermination process.
“That’s a little bit more than we were even expecting for this time,” said Audrey Morse Gasteier, executive director of the Massachusetts Health Connector, on The Codcast. “The topline is it’s early days but we are seeing strong activity. The operations are holding.”
After a three-year hiatus brought about by COVID, April 1 was the start date for the redetermination process, which seeks to verify that those on Medicaid are entitled to receive it. Roughly 2.3 million Medicaid recipients need to be assessed, with early predictions estimating 300,000 residents on MassHealth could be dropped from the rolls. The big concern is that those who are dropped quickly find new coverage, which is why those affected are automatically told whether they qualify for health plans at the Connector.
“There are some states that don’t particularly mind shedding folks off of their Medicaid rolls and aren’t particularly concerned where people land. That’s obviously not the case with Massachusetts,” Gasteier said. “We have 97 percent of our residents in coverage. We don’t want to see backsliding on that. We don’t want to see people losing their coverage and becoming uninsured.”
The 97 percent coverage rate is the highest in the nation, but Massachusetts hasn’t been able to trim it more. “We think about this every day. That last 3 percent has been a challenge,” Gasteier said.
She said the uninsured group is made up primarily of young Hispanic males, most of them immigrants. And about half of them had coverage at some point, which is why the churn caused by the Medicaid redetermination process is worrisome.
The Connector, one of 17 state-run health care exchanges (the rest are managed by the federal government), offers a one-stop shop for every type of health care coverage, including subsidized coverage for income-eligible residents. Nearly 250,000 people use the Connector, and a quarter to a third of them qualify for subsidized plans.“We make the entire market available to you in an organized, curated way so you can make informed comparisons between coverage options,” Gasteier said. “It’s the only place people can get help paying for coverage.”
Cost remains a concern, Gasteier said, with family coverage costing as much as $25,000 a year. “It’s just untenable,” she said. “It is not where it needs to be and the pain that families across the Commonwealth are feeling we see constantly in data about rising costs. It’s just a stranglehold on individual households, on small businesses, and others and really feels like it’s approaching an emergency level.”