Latest news with #HealthSafetyNet
Boston Globe
17-07-2025
- Health
- Boston Globe
One big disaster for Massachusetts health care
Get The Gavel A weekly SCOTUS explainer newsletter by columnist Kimberly Atkins Stohr. Enter Email Sign Up One major impact of the bill they'll need to contend with is the new administrative barriers, like work requirements, it created for enrollees in MassHealth, the state Medicaid program for low-income residents. Advertisement While the vast majority of Medicaid recipients are already working or would qualify for an exemption, states with work requirements typically State officials should work with community organizations, health care providers, and consumer advocates like Health Care for All on a public education and assistance campaign that informs MassHealth enrollees of the new requirements and helps them fill out paperwork. Advertisement The bill will also require states to redetermine enrollees' eligibility for MassHealth twice a year instead of annually. To satisfy that requirement, the state should also work on establishing automated systems that let information be verified through data-matching, so the state uses information it collects through other state agencies (like unemployment insurance filings) to confirm eligibility for MassHealth. The good news is state officials While the goal should be keeping people insured, some residents will lose insurance for paperwork reasons, or because they can no longer afford it, or because they lose eligibility. For example, many immigrants who have legal status in the US but not permanent residency (like refugees or asylum seekers) will no longer be eligible for Medicaid or for subsidies from Massachusetts' Health Connector. It's also still unknown whether Congress will extend Of course, people without insurance will still get sick, and they are likely to land in hospital emergency rooms. Massachusetts' Health Safety Net fund, which helps hospitals pay for uncompensated care, is The financial hits to Medicaid will come from several policy changes included in the bill. The biggest ones are restrictions on the extent to which the state can rely on provider taxes and state-directed payments, which are complicated methods by which the state uses state money (including fees collected from hospitals and providers) to draw federal Medicaid matching money, then distributes that money back to health care providers (hospitals, nursing homes, and community health centers). Advertisement There are no easy answers as the Legislature and governor decide how to respond. Lawmakers will likely face pressure to raise new revenues through taxes or dip into the state's $8.1 billion rainy day fund to avoid major cuts to MassHealth benefits or eligibility. But the magnitude of the cuts will make it impossible for the state to backfill the entire amount. At the same time, ripples from the Medicaid cuts will affect the entire health care system. The organization There will likely be targeted areas where the state will want to replace federal with state money — for example, if money is need to avoid the shuttering of essential services, like a rural hospital's emergency room or the sole regional facility for labor and delivery. There may need to be cuts to MassHealth benefits, and enrollees will be forced to pay new federally required copays for many services. Some rates paid to providers may be cut. Advertisement Massachusetts also needs to negotiate a new waiver with federal Medicaid officials by the end of 2027, which sets the parameters around how MassHealth is structured and what services the federal government will cover. Massachusetts Congressman Jake Auchincloss suggested, in an interview with the editorial board, that the state could seek to negotiate more state flexibility and autonomy in running its own program — for example, to make enrollment easier, to experiment with pilot programs, do more with alternative payment systems, or get paid for investments that save Medicare money, like community-based care for seniors. During the COVID-19 pandemic, the state convened state policy experts and stakeholders to respond to the crisis. The Healey administration should consider reviving that model today. In a time of scarcity, it's tempting for each segment of the industry to protect its turf. It would be far better to put state policy makers in a room with representatives of hospitals, community health centers, insurers, nursing homes, drug companies, patient advocates, and other health system stakeholders so they can collaborate and chart a path forward that's in the best interest of the Commonwealth's residents. Editorials represent the views of the Boston Globe Editorial Board. Follow us
Yahoo
22-05-2025
- Health
- Yahoo
GOP bill raises fears of major reduction in home care for seniors, disabled
Rep. Judy Chu (D-Ca.) said she worries over the future of at-home care for seniors if President Donald Trump's federal funding package passes in the House. Trump's 'big, beautiful bill' proposes cutting billions from social benefit programs, including $800 billion from Medicaid and $300 billion from the Supplemental Nutrition Assistance Program (SNAP). Chu called the proposed reduction in Medicaid funding the most 'devastating cut to services for seniors in our lifetime' since it will force states to heavily reduce the amount of money they spend on at-home care for older people and people with disabilities. 'This will be really tough for seniors if these cuts go through,' Chu said during The Hill's Health Safety Net Programs: Will Older Adults Fall Through? More than 7 million Americans over 65 are enrolled in Medicaid, and 11 million adults between the ages of 50 and 64 receive health care coverage through Medicaid, according to the program's website. Medicaid also provides health insurance coverage to about 5 million disabled Americans. Medicaid is also a major funder of nursing home care. Medicare, the federal health insurance program for Americans 65 and older, only covers short nursing home stays. Medicaid will often pay for Longer-term nursing home stays and at-home care for low-income Americans who qualify. The program pays more than 60 percent of long-term care residents in nursing homes, according to reporting from KFF Health News. The proposed Medicaid cuts have received pushback from disabled and older Americans across the country. Medicaid cut protesters disrupted a House Committee on Energy and Commerce meeting last week as lawmakers began a marathon markup session. Capitol Hill police arrested 26 people and removed several protesters in wheelchairs as they shouted phrases like 'keep your greedy hand off our Medicaid' and 'no cuts to Medicaid' at lawmakers. Protests urging lawmakers to oppose the proposed Medicaid cuts have popped up around the country, including in New York, New Hampshire, and California. Several Democratic lawmakers, including Chu, have held town halls in their districts about the proposed Medicaid cuts in the federal spending package. Chu told The Hill that her constituents in southern California are 'incredibly fearful' and 'anxious' over the possible cuts. 'They feel devastated by the potential cuts that could happen to them and to their fellow neighbors,' said Chu. 'I have never seen such passion in my life, they have turned out in record numbers at the town halls, the pack each one of them.' It's clear, she added, that Americans across the country are 'feeling these devastating cuts very personally.' Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
The Hill
22-05-2025
- Health
- The Hill
GOP bill raises fears of major reduction in home care for seniors, disabled
Rep. Judy Chu (D-Ca.) said she worries over the future of at-home care for seniors if President Donald Trump's federal funding package passes in the House. Trump's 'big, beautiful bill' proposes cutting billions from social benefit programs, including $800 billion from Medicaid and $300 billion from the Supplemental Nutrition Assistance Program (SNAP). Chu called the proposed reduction in Medicaid funding the most 'devastating cut to services for seniors in our lifetime' since it will force states to heavily reduce the amount of money they spend on at-home care for older people and people with disabilities. 'This will be really tough for seniors if these cuts go through,' Chu said during The Hill's Health Safety Net Programs: Will Older Adults Fall Through? More than 7 million Americans over 65 are enrolled in Medicaid, and 11 million adults between the ages of 50 and 64 receive health care coverage through Medicaid, according to the program's website. Medicaid also provides health insurance coverage to about 5 million disabled Americans. Medicaid is also a major funder of nursing home care. Medicare, the federal health insurance program for Americans 65 and older, only covers short nursing home stays. Medicaid will often pay for Longer-term nursing home stays and at-home care for low-income Americans who qualify. The program pays more than 60 percent of long-term care residents in nursing homes, according to reporting from KFF Health News. The proposed Medicaid cuts have received pushback from disabled and older Americans across the country. Medicaid cut protesters disrupted a House Committee on Energy and Commerce meeting last week as lawmakers began a marathon markup session. Capitol Hill police arrested 26 people and removed several protesters in wheelchairs as they shouted phrases like 'keep your greedy hand off our Medicaid' and 'no cuts to Medicaid' at lawmakers. Protests urging lawmakers to oppose the proposed Medicaid cuts have popped up around the country, including in New York, New Hampshire, and California. Several Democratic lawmakers, including Chu, have held town halls in their districts about the proposed Medicaid cuts in the federal spending package. Chu told The Hill that her constituents in southern California are 'incredibly fearful' and 'anxious' over the possible cuts. 'They feel devastated by the potential cuts that could happen to them and to their fellow neighbors,' said Chu. 'I have never seen such passion in my life, they have turned out in record numbers at the town halls, the pack each one of them.' It's clear, she added, that Americans across the country are 'feeling these devastating cuts very personally.'
Yahoo
06-03-2025
- Health
- Yahoo
State orders open access to free prenatal vitamins, birth control
BOSTON (SHNS) – Eligible MassHealth members and Health Safety Net patients will have access to prenatal vitamins and over-the-counter birth control at no cost, under two standing orders that the Healey administration announced Thursday. The orders, which essentially enable the state to write a prescription for a large group of people, will allow about half a million patients to access the reproductive health medications. The medications will be available at all MassHealth-enrolled pharmacies, and available for eligible MassHealth members and those who use the Health Safety Net, a fund used to pay care costs for certain low-income and uninsured individuals. MassHealth currently covers 40 percent of all births in Massachusetts, according to the Healey administration. 'Removing barriers like this is one of the simplest ways we can work toward better health outcomes for mothers and infants in our state,' Health and Human Services Secretary Kate Walsh said. The standing order covers a 90-day supply of over-the-counter prenatal vitamins or multivitamins containing at least 400 mcg of folic acid, a B vitamin that helps bodies create new cells. Doctors recommend that people considering getting pregnant, pregnant, or nursing, take these vitamins. Pharmacists will be required to counsel patients on the use of prenatal vitamins, including when to start and stop taking them, and encourage follow-up with a primary care provider and obstetrician/gynecologist. The second standing order covers oral hormonal contraceptives. It allows pharmacists to give out a 365-day supply of over-the-counter birth control pills — specifically norgestrel 0.075 mg tablets — to eligible MassHealth members and HSN patients. It specifies that birth control is 'accessible to individuals of reproductive potential and age,' according to Healey's Executive Office of Health and Human Services. 'As part of this initiative, pharmacists will be required to counsel patients on contraindications, side effects, and the proper use of the birth control pill, emphasizing the importance of daily adherence and informing patients that the pill does not protect against sexually transmitted infections,' information from EOHHS says. 'We know that prenatal vitamins and birth control play an essential role in women's health. No one should be prevented from getting the care they need because of cost or because they are waiting for a prescription,' Healey said in a statement. 'These standing orders will make it easier and more affordable for people to make the best health care decisions for themselves, will improve health outcomes for women and babies, and will reduce health disparities.' Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Boston Globe
06-03-2025
- Health
- Boston Globe
Massachusetts' charity care fund is running on empty
Advertisement The solution was for all hospitals and insurers to pay an annual fee into a Health Safety Net fund, which reimburses a portion of the free care provided by community health centers and hospitals. Get The Gavel A weekly SCOTUS explainer newsletter by columnist Kimberly Atkins Stohr. Enter Email Sign Up The good news is the program worked as intended, partially compensating health care providers for treating patients who lack insurance or have insufficient insurance, a population that is overwhelmingly low income. The bad news is the program no longer has anywhere near enough money to cover the care hospitals provide. In fiscal 2023, the To be sure, hospitals receive public benefits like tax breaks in exchange for providing their communities with charitable care. And many hospitals Advertisement The shortfall raises an important question: Are more people uninsured or underinsured today, and what can be done about it? It also suggests that after 19 years, Health Safety Net funding needs updating. A MassHealth spokesperson said MassHealth lacks data to support the idea that the uninsured rate is causing the shortfall. The latest official data, from 2023, say only Anecdotally, though, experts suggest this number may be increasing. Dr. Eric Dickson, president and CEO of UMass Memorial Health, said his hospitals see many newly arrived immigrants who don't have insurance or have public insurance that only covers emergency care. New arrivals may be ineligible for insurance due to immigration status or may not know what they are eligible for. Peter Banko, president and CEO of Baystate Health, said that system has seen a sixfold increase over seven years in unpaid debt from people who are employed but low-income. These people may have high-deductible health plans and can't afford the deductible and may delay care until a medical situation worsens. The state also recently reviewed eligibility for all MassHealth enrollees. Hannah Frigand, who oversees Health Care for All's consumer helpline, said some people who were deemed ineligible for MassHealth have not reenrolled elsewhere. Some may be eligible for employer-sponsored insurance but didn't take it because it was too expensive or they missed open enrollment. One important step to reducing the shortfall is ensuring everyone who is insurance-eligible is enrolled. Another issue is simply the growing cost of care. Every year, hospitals cumulatively pay $165 million into the Health Safety Net; insurers pay another $165 million; and state government last year paid $16 million. The problem is the amounts were set in law when the Health Safety Net was created, without accounting for inflation. Then, the assumption was the need for the pool would lessen as more people obtained insurance. Instead, people have continued to be uninsured and underinsured, and costs of care have climbed. Advertisement Since the COVID-19 pandemic, there has been growing demand for care, combined with increasing costs for health care and prescription drugs. The Health Safety Net reimburses hospitals based on Medicare rates, so as those rates rise with inflation, applications for reimbursement rise. According to the Health Safety Net's A MassHealth spokesperson said the Health Safety Net 'is reviewing its policies to better support providers who serve uninsured or underinsured patients.' There is likely room to revise the distribution formula to better prioritize hospitals that care for the lowest income patients, while also revising the funding formula to account for inflation. Anyone who presents at a hospital can and should get care. Finding the fairest way to pay for that care remains a work in progress. Editorials represent the views of the Boston Globe Editorial Board. Follow us
