Uninsured Face Health Plan Delays

UNINSURED FACE HEALTH PLAN DELAYS: STATE DELUGED WITH APPLICANTS

The number of people seeking state-subsidized health insurance has overwhelmed the offices processing applications, forcing some of the uninsured to wait months to get coverage, according to Massachusetts state officials and healthcare advocates.

Applicants routinely have to submit the same paperwork twice or even three times, because it is getting lost in state offices, advocates say, and many are getting confusing or contradictory information about whether they qualify. The loss of paperwork "happens to over 50 percent of our clients," said Camila De Oliveira, program director of the Community Action Committee of Cape Cod & Islands, which helps people apply.

The state official overseeing the application process acknowledged the delays and said the state is working to solve the problem. The volume of applications is nearly double what MassHealth handled last year before Commonwealth Care began. Although MassHealth increased the number of hours staff members devoted to processing applications and added people to answer questions by phone, it has not been enough to keep pace.

The state's goal is to get back to applicants within five days, telling them whether they qualify for either program or must submit additional information. State officials report they are meeting that goal for most of the people who apply electronically. But about half the applications come in on paper, and it is taking an average of 22 days to handle those.

Residents who qualify for MassHealth are enrolled immediately. But if the state declares a person eligible for Commonwealth Care, they must still choose a health plan and in some cases pay a premium before they are covered, which can add another month to the process.

To fix the larger issue of eligibility delays, the state is authorizing overtime for MassHealth employees working to reduce the backlog of applications.

In addition, MassHealth is seeking to reduce the paperwork required for applications by allowing electronic signatures. The agency is also retraining workers to be sure they are providing correct and clear information to applicants. MassHealth is also setting up an ombudsman to help resolve individual problems.

"We're really encouraged," said Brian Rosman, a leader of the Affordable Care Today Coalition, after meeting with Dehner. "But we'll wait and see if they deliver on what they say they're going to do."

To get eligibility information for MassHealth or Commonwealth Care, or to check the status of an application, call 888-665-9993. Information about Commonwealth Care is available at macommonwealthcare.com or by calling 1-877-623-6765.

-Adapted from “Uninsured face health plan delays: State deluged with applicants” By Alice Dembner, The Boston Globe, August 11, 2007, at http://www.boston.com/news/local/articles/2007/08/11/uninsured_face_health_plan_delays/ .