Effort to help Massachusetts residents maintain Medicaid MassHealth benefits
At a community health center in downtown Lowell, Abbas Tanner, a patient navigator, was busy making phone calls to assist individuals with renewing their insurance from MassHealth, the state Medicaid program. One of his recent calls was with a 29-year-old woman from Leominster who needed help in renewing her coverage. Tanner asked her questions about her family, income, and immigration status, typing her answers on his laptop. With the assistance of an interpreter, Maria Cruz, who translated into Portuguese, they successfully renewed the woman's insurance under MassHealth after about 15 minutes.
This work of guiding people through the process of obtaining health coverage is crucial at this time. It is part of a comprehensive effort across Massachusetts to ensure that low-income families and individuals can maintain access to healthcare during a challenging period for MassHealth. During the COVID-19 health emergency, federal rules allowed Medicaid recipients in Massachusetts and other states to retain their benefits indefinitely, even if their income increased. However, this grace period has ended, and individuals now need to prove their eligibility. If they fail to receive their renewal notice or respond in a timely manner, they risk losing their health coverage entirely.
The burden is particularly heavy for immigrants and communities of color who may not speak English fluently or have easy access to technology. Brenda Rodriguez, the chief strategy and finance officer at Lowell Community Health Center, highlighted that the most vulnerable individuals are often the ones who slip through the cracks. They may lack a computer or a working cell phone to complete online forms, or they may encounter other barriers.
State officials in Massachusetts are investing at least $11 million in a campaign to reach the one in three state residents who rely on MassHealth. The stakes are high, as individuals who lose their insurance may be less likely to seek healthcare when needed or could face substantial medical bills. There are also broader implications, as Massachusetts' landmark 2006 health care law served as a blueprint for the Affordable Care Act, and over 97% of the state's residents are insured. A decline in this number would be a setback for a state known for prioritizing access to healthcare. Mike Levine, the assistant secretary for MassHealth, emphasized that universal coverage is their ultimate goal.
MassHealth currently covers 2.4 million people, and state officials aim to automatically renew up to half of them using income data from public programs. Although they are lagging behind this target, they are actively working to achieve it. The process of determining eligibility for MassHealth began in April and is expected to take a year. Renewal notices are being mailed to members in blue envelopes each month, allowing them at least 45 days to respond.
However, there are concerns that individuals may not receive these critical mailings from MassHealth due to address changes or may receive the letter without understanding the need to respond. According to the health policy nonprofit KFF, between 8 million and 24 million people nationwide may lose Medicaid coverage during this verification process, often because they fail to respond to renewal notices despite being eligible for benefits.
Data from states that have expedited their Medicaid enrollment review already demonstrate that over 70% of individuals are losing coverage for procedural reasons, such as not returning forms, according to KFF. Levine acknowledged that this early data from other states underscores the importance of outreach and education to prevent inadvertent loss of coverage. He emphasized the state's commitment to minimizing this number as much as possible. Massachusetts' campaign to reach MassHealth members includes community events, TV ads, calls, and text messages.
Outreach workers are going door to door in Chelsea, Brockton, Framingham and a dozen other communities with big numbers of residents on MassHealth. They knocked on more than 260,000 doors and talked to 55,000 people in just two months. If MassHealth members don't take action to renew, "there's a possibility that they may lose coverage — and that's what nobody wants," Gonzalez said.
We understand how difficult it can be to navigate the MassHealth system, and that's why we want to help. If you or someone you know is at risk of losing their Medicaid benefits, we urge you to reach out to our law firm for assistance. We can help draft the renewal application to ensure that all necessary information is included and that it is submitted on time.