MASSHEALTH ESSENTIAL REACHES CAP

As of December 14th, the state has closed enrollment in the MassHealth Essential program. New applicants are being placed on a waiting list. There is a possibility that with federal approval, the state could re-open the program, but for now, providers should continue to assist patients with applications, in the hopes that they will be found eligible for a different program during the MassHealth screening process. The waitlist will be necessary to help demonstrate and advocate for the need for the program.

The Romney administration applied (recently) for federal permission to expand the program but is still waiting for approval, according to Dick Powers, a spokesman for the state Executive Office of Health and Human Services.

In setting the cap, the Legislature also gave the administration permission to enroll more than 36,000 people in the program if doing so would not push spending over $160 million. Powers said more Massachusetts residents could be added to MassHealth Essential without going over budget.

He said the administration had been seeking informal approval from the federal government for several months to do that but learned only last week that the state has to formally apply for permission.

Some advocates have criticized the Romney administration for not moving faster.

-Adapted from “ Medicaid enrollment reaches cap : Applicants put on waiting list” by Alice Dembner and Scott Greenberger, The Boston Globe, December 16, 2004 and e-mail from Kim Simonian, Partners Community Benefits.