AS THE STATE prepares to drop hundreds of thousands of people from the MassHealth insurance program, government and community leaders are hoping for a smooth year-long process – but bracing for possible chaos.
When the COVID-19 pandemic emergency hit, Massachusetts hit pause on the annual process of figuring out who continues to qualify for the state’s Medicaid program for low-income and disabled residents and the Children’s Health Insurance Program (CHIP). Using federal pandemic funding, coverage for MassHealth recipients was automatically extended during the global health crisis.
That’s set to change in just a few days. April 1 marks the first time in three years that the state will begin combing through the insurance rolls to make sure that the only people receiving the coverage are those who are still eligible.
That redetermination process needs to happen for some 2.3 million MassHealth recipients. Mike Levine, the assistant secretary for MassHealth, said in early March that about 300,000 people will likely lose their coverage and be redirected to other health care.
MassHealth officials will have 12 months to work through every member.
“It’s a marathon, not a sprint,” Levine told legislators at a Joint Ways and Means Committee hearing in Arlington on Tuesday. “We’re not redetermining 2.3 million people on April 1.”
For those on MassHealth who still qualify and can be automatically renewed – about half of all recipients, officials estimate – they will get a letter in the mail letting them know that no action is needed. If MassHealth needs updated information, the member will receive a blue envelope in the mail. The member then has 45 days to respond by mail, email, or phone call, which could kick off another three month window to send more information if needed.
In partnership with MassHealth and the Health Connector, the nonprofit consumer advocacy organization Health Care For All is engaged in a statewide effort to publicize the redetermination. Regional health groups are also working to eliminate coverage gaps.
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