Medicaid Waiver Extension Aids Insurance

Commonwealth Care marked its second anniversary on Wednesday, a day after receiving a federal go-ahead to continue the popular insurance program.
The state-subsidized health insurance program was launched in 2006 as part of the landmark healthcare reform law, and according to Jon Kingsdale, executive director of the Commonwealth Health Insurance Connector Authority (CHICA), approximately 170,000 have coverage through Commonwealth Care as of September.
The program was designed to provide coverage for low-income residents who could not obtain coverage through an employer. Adults with annual incomes of up to 150 percent of the federal poverty level ($15,612 for an individual, $31,812 for a family of four) can obtain completely subsidized coverage, while adults earning 150 to 300 percent of the FPL can receive partially subsidized coverage.
Commonwealth Care saw greater than anticipated participation in its early stages, but enrollment has leveled off and is below state estimates. The state originally predicted that 215,000 would qualify and enroll in a Commonwealth Care program by the end of 2007, that projected enrollment based on an estimate of 460,000 uninsured residents. That estimate was later scaled back to 160,000 participants.
The original projected cost of the Commonwealth Care program was $472 million for its first year, but the actual cost was $630 million. Current projections estimate that by 2011 approximately 342,000 people will have enrolled in Commonwealth Care, and the program’s annual expenses will have hit $1.35 billion.
Mr. Kingsdale said the CHICA would be working extensively with Governor Deval L. Patrick and the Legislature “to pursue and develop cost-saving initiatives that keep health insurance affordable for both enrollees and taxpayers.”
One good sign for the program’s future, according to Mr. Kingsdale, is the reduced use of the state’s Health Safety Net Fund, formerly the “Uncompensated Care Pool” or “Free Care Pool.” Hospital and medical clinic visits paid for by the fund dropped by 44 percent in the first quarter of Fiscal Year 2008 as compared to the same period in FY07, and payments from the fund dropped 41 percent in that time, from $165 million to $97 million.
“That’s another strong indicator that healthcare reform is working exactly as it was intended,” Mr. Kingsdale said.
This week saw another positive development, the approval Tuesday of a crucial Medicaid waiver allowing the state to spend its federal Medicaid dollars on Commonwealth Care. The previous waiver was set to expire June 30, 2009.
Massachusetts is also set to receive a $4.3 billion increase in Medicaid funding over the coming three years.
“This new federal agreement ensures we can build on that success and continue to work toward universal coverage,” Governor Patrick said in a press release. “I thank our partners in Washington, especially Senator (Edward M.) Kennedy and Health and Human Services Secretary Michael Leavitt, for supporting our historic efforts to deliver to all our citizens the care that improves people’s lives.”
Overall, approximately 440,000 previously uninsured residents have obtained health insurance since the passage of the health care law.