California Healthline Daily Edition

Summaries of health policy coverage from major news organizations

Cost of Massachusetts Health Overhaul To Double Over Three Years

Enrollment and costs for Commonwealth Care, Massachusetts' subsidized health insurance program, are expected to double by June 2011, the Boston Globe reports.

The growth "would far outstrip the original plans" for the program, mainly because state officials underestimated the number of residents without health insurance, the Globe reports. Commonwealth Care provides no-cost or subsidized health care coverage to state residents who do not qualify for MassHealth, the state's Medicaid program, and do not have access to employer-sponsored health insurance.

When the program was authorized in 2006, the state Legislature projected total eventual enrollment of 215,000 people at a cost of $725 million annually, but officials in late 2006 reduced the estimate to between 140,000 and 160,000.

However, state projections obtained by the Globe estimate enrollment of 342,000 people at a cost of $1.35 billion annually within three years. Currently, about 169,000 residents are enrolled in the program.

Total spending on the state's health care initiative will equal $1.95 billion this year, with just less than half being funded by the federal government. Two unforeseen problems have contributed to the funding shortfall:

  • The state had expected to shift money from no-cost care for the uninsured to insurance subsidies, but the decline in charity care has been slower than expected; and
  • The state had expected to collect tens of millions of dollars from the penalty on businesses that do not offer health coverage to workers, but it expects to collect about $5 million this year.
Search for Funding

The state has requested that the federal government pay for half of the program's costs between 2009 and 2011, but that funding is not guaranteed. Gov. Deval Patrick (D) is seeking about $1.5 billion in federal funds over three years, and funding negotiations between Patrick's administration and federal officials are expected to conclude by July 1.

Beyond funding for Commonwealth Care, the state also is seeking federal funding to expand MassHealth. If Massachusetts "doesn't get all of the federal funds it is seeking, policymakers could face difficult choices: spend more state money or cut back the two programs by reducing enrollment, cutting subsidies or eliminating benefits," the Globe reports.

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