MassHealth enrollment down by more than 110,000
In October, approximately 88,000 individuals in Massachusetts lost MassHealth coverage, marking the largest monthly decline in the year-long effort to reassess eligibility for the program's 2.4 million members. The majority of those losing coverage were impacted for procedural reasons.
During the initial seven months of the reassessment process, 46% of individuals removed from MassHealth lost coverage due to confirmed ineligibility, while 52% faced disenrollment because state workers lacked sufficient information for eligibility assessment, according to state health and human services officials.
Data published by state health and human services officials revealed a cumulative drop of 112,000, or 4.67%, in the combined Medicaid and Children’s Health Insurance Program rolls since April. State officials anticipate a nearly triple increase in disenrollments over the remaining five months of the federally mandated redetermination campaign, especially after the open enrollment period at the Massachusetts Health Connector.
The Massachusetts Health Connector, a state-run insurance marketplace, witnessed increased interest during the redetermination process. MassHealth officials reported a growth of 38,000 enrollments since April, indicating that many individuals losing MassHealth eligibility found affordable coverage through the Connector.
All 50 states are currently reassessing Medicaid eligibility, following the end of the federal prohibition on Medicaid removals during the COVID-19 pandemic. States must now determine who qualifies for publicly funded health insurance.
Despite 22,000 new enrollments in MassHealth in October, the ongoing campaign is projected to result in a net reduction of 300,000 to 400,000 members, freeing up $1.9 billion in funds for allocation in the state budget, as initially estimated by Healey administration officials.
The share of disenrollment for procedural reasons has been rising, posing challenges in interpretation. MassHealth Chief Operating Officer Elizabeth LaMontagne emphasized the anticipation of a significant number of members losing coverage by the end of the year, aligning with typical annual trends during the open enrollment period.
Assistant Secretary for MassHealth Mike Levine acknowledged the complexity of interpreting data, particularly distinguishing between those intentionally ignoring contact and those who may still qualify but face challenges in response. The data reports do not currently distinguish between these two populations, posing a challenge for accurate interpretation.
The rejoining of MassHealth by around 11,000 people in October within three months of departure is a notable data point being closely monitored to understand the dynamic of eligibility changes. Levine highlighted the importance of reducing procedural issues leading to such reenrollments.
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