Redetermine Data Shows 93 Percent Still Eligible for MassHealth, Connector Subsidies

Massachusetts Connector

7-24-15 Feature Story:

Following is an article written by State House News Service Editor Michael Norton on state efforts to re-determine eligibility for Massachusetts' 1.2 million MassHealth enrollees.

State officials engaged in the labor-intensive process of determining whether 1.2 million Medicaid enrollees remain eligible for heavily subsidized health care coverage have reviewed information from 387,000 people and found that nearly four out of every five remain eligible for MassHealth coverage.

According to the Executive Office of Health and Human Services, 78 percent of the individuals who were reviewed are still eligible for MassHealth and another 15 percent are eligible for subsidized health insurance coverage through the Massachusetts Health Connector Authority.

Web site failures at the state Connector Authority caused the redetermination process, which is federally required annually, to come to a halt in October 2013 and Gov. Charlie Baker's administration at the outset of 2015 mailed redetermination letters to 503,000 MassHealth enrollees, with plans to complete all 1.2 million redeterminations by the end of 2015.

In addition to those deemed still eligible for MassHealth (229,149) or eligible for subsidized coverage through the Connector (42,609), 5 percent of MassHealth enrollees reviewed (16,057) were considered eligible for unsubsidized care at the Connector that could include eligibility for federal tax credits under the Affordable Care Act. About 2 percent (7,740) were deemed not eligible for MassHealth or Connector coverage.

About 78 percent of enrollees who were mailed redetermination information responded, which Baker administration officials said is higher than the "historical experience" of a 70 percent response rate.

- Michael Norton/SHNS
7/22/2015 11:59:58 AM


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