STATE SUPPLEMENTAL BUDGET

On Thursday September 9, 2004 the Massachusetts legislature approved a supplemental budget. What follows are highlights of the programs effected.

Immigrant MassHealth Coverage

The legislature included a provision in the supplemental budget that would have extended full MassHealth coverage for the 2,700 legal immigrants who are elderly and disabled which had been cut and then was reinstated for the past three months- ending today (October 1). It was not vetoed by Governor Romney, but was returned with the following amendment: “Any alien aged 19 or over shall not receive benefits under this section unless the alien has or had a sponsor, as defined in Federal law, and the sponsor is deceased or unable to provide the alien with financial support as determined by EOHHS.”

Although the wording of the amendment is vague and could be difficult to operationalize, the Governor did leave half of the allocated funds for this provision in the budget ($2 million of $4 million remains), so it seems he did intend for it to cover some individuals. According to the language in this amendment, non-sponsored immigrants will be ineligible and it is unclear how "ability to support" (for the sponsored immigrants) will be determined. For example, would the sponsor be exempt if he/she were at a certain Federal Poverty Level? Unfortunately, this provision will significantly cut the number of eligible immigrants. No one seems to know for sure how many of the 2,700 immigrants in question actually have a sponsor.

Now, the Legislature must act on this to either enact this provision with the amendment or to modify and return to the Governor for approval. The legislature is not scheduled to return to formal session until January 1, 2005. As far as the October 1st cut-off date, the Division of Medical Assistance has not yet sent out warning notices to clients concerning being cut from benefits. Please advise your clients to do their best to take care of their medical needs in the next few weeks as coverage may cease soon. MIRA and other advocates are working with DMA to try to delay the cut-off of these elderly and disabled immigrants since the budget did include $2 million to continue coverage.

MassHealth Essential & Overall Growth in MassHealth Caseload

The state is anticipating a 7% growth in its MassHealth caseload this year, primarily due to the fact that anyone applying for Free Care will be required to complete an MBR and be screened for MassHealth. MassHealth Essential enrollment is at 30,000; the program is capped at 36,000 enrollees, or $160 million. Given the change with the MBR requirement for Free Care applicants, the state expects that this cap will be reached soon.

Expansion of HIV Coverage to 200% FPL

Although this expansion was approved in the state budget, the Office of Medicaid still needed to seek federal waiver approval from the federal Centers for Medicare and Medicaid Services (CMS). This was supposed to be a formality, given that this change was simply a reversal back to the prior coverage level; however, CMS has been slow to approve this request. MassHealth can’t cover anyone between 133% and 200% on the HIV program until the waiver is approved, and there is no retroactive coverage. Once waiver approval is received, the state will send letters to those who lost coverage last year because they were in this income range (about 125 members) and inform them they will need to reapply.

-Adapted from materials forwarded by Kim Simonian, MPH, Access to Benefits Coordinator, Partners Community Benefits, including Health Care for All MassHealth Defense Group Meeting Notes September 21, 2004, and Carly Burton, Policy Associate, Massachusetts Immigrant and Refugee Advocacy Coalition

09/2004