MGH Community News

October 2020
Volume 24 • Issue 7

Highlights

Sections


Social Service staff may direct resource questions to the Community Resource Center, Hannah Perry, 617-726-8182.

Questions, comments about the newsletter? Contact Ellen Forman, 617-726-5807.

The End of the State Eviction Moratorium and Baker’s Rental Relief Plan

With the end of the State’s eviction moratorium on October 17 the federal CDC Eviction Moratorium may protect many at least through the end of 2020.

CDC Eviction Moratorium

The federal CDC Eviction moratorium is still in effect until at least the end of the year. But it is NOT automatic; tenants must sign and give this declaration to their landlord, and it does not offer as comprehensive protection as the state version. Unlike the MA moratorium it does NOT prohibit late fees. 

  •  Tenants still can be evicted for reasons other than nonpayment of rent. At-risk renters need to meet the requirements spelled out in the CDC notice and sign and share this declaration with their landlord. 
  •  The Declaration has been translated into multiple languages. More information here. 
  • The protection applies to new and already-filed evictions so long as the tenant completes the declaration. 
  • Tenants are encouraged to make partial payments to their landlords.

 -This section adapted from: Legal Problem-Solving Tips as MA Eviction Moratorium Expires Sat., 10/17, Samantha Morton, MLP Boston, October 15, 2020  

CDC Moratorium Eligibility 

Renters must meet the following qualifications:

  • You have used your “best efforts” to obtain government rental assistance; 
  •  You do not expect to earn more than $99,000 in 2020 (or $198,000 if you are married and filed a joint tax return), or you did not need to report income to the federal government in 2019, or you received an Economic Impact Payment this year; 
  •  You have been experiencing a “substantial” loss of household income because of a layoff or reduced work hours, or you have “extraordinary” out-of-pocket medical expenses (defined as an unreimbursed medical expense that exceeds 7.5% of your adjusted gross income for the year); 
  •  You have been making your best effort to make partial rent payments as close to the full amount due as possible; and 
  •  Being evicted would cause you to become homeless or you would have to move in with a friend or family member (live “doubled up”). 
- More information: National Eviction Moratorium: FAQ for Renters and Overview Of National Eviction Moratorium (National Low Income Housing Coalition and the National Housing Law Project)

 

 MA Eviction Diversion Initiatives

The Baker administration on October 12, 2020 unveiled a $171 million initiative that includes new aid for landlords and tenants as well as increased funding for court-sponsored mediation efforts and rehousing programs if tenants do get evicted. 

Please note that some of these new funds and programs will not be immediately available as the programs are implemented, funding disbursed, etc. 

Changes include:  

  •  RAFT/ERMA Homelessness Prevention Funds
    • Additional $100 million funding to RAFT
    • Starting on October 19, 2020, a special COVID Response RAFT benefit level will increase the maximum benefit available through RAFT from $4,000 to $10,000 per household, with a goal of helping more families stabilize their housing for six months, or until the end of June if there are school-age children in the household, on their path to recovery.
    • Updating the RAFT program to improve turnaround time on applications, while maintaining program integrity, by:
      • streamlining the application process for both the RAFT and Emergency Rental and Mortgage Assistance (ERMA) programs for low to moderate income households;
      • verifying applicant eligibility with data collected through MassHealth, the Department of Transitional Assistance (DTA), Department of Unemployment Assistance (DUA), and the Department of Revenue (DOR);
      • referring applicants to MassHIRE Career Centers; and
      • allowing landlords who own fewer than 20 units to apply directly for RAFT and ERMA, with consent from tenants.
  • Expanding access to mediation services PRIOR to a court filing. In coordination with the Trial Court, the Administration is working to launch a new Community Mediation program that will be available prior to a court filing, and supplement court-provided mediation that is generally available after a filing has been made. 
  • Additional $48.7 million to HomeBASE and other rapid rehousing programs to help those who are evicted and facing homelessness
  • Additional $12.3 million to provide tenants and landlords with access to legal representation and related services prior during the eviction process, and community mediation to help tenants and landlords resolve cases outside of court
  • Additional $6.5 million for Housing Consumer Education Centers, which provide resources, services and help answer questions about all housing problems
  • Additional $3.8 million for the Tenancy Preservation Program, a homelessness prevention program. This short term expansion of TPP will launch in the coming weeks.
  • New programs to connect income eligible landlords and tenants to legal help are in development but will not operational for several weeks.

For More information on the Eviction Diversion Initiative

Eviction Diversion Initiative Resources

Get Help/Refer Patients
The state has kicked off a public information campaign, including a new option available to call the Massachusetts 2-1-1 information hotline. Operators for 2-1-1 are trained to answer questions and connect residents to the agencies that administer RAFT and ERMA.

Find a local regional agency to apply for RAFT/ERMA, education and assistance: https://hedfuel.azurewebsites.net/raa.aspx

See the state’s website: https://www.mass.gov/info-details/emergency-housing-assistance-during-covid-19

Realities on the Ground- RAFT Can’t Meet Demand 

Unfortunately advocates are reporting long delays in processing RAFT applications. Yet tenants and landlords alike - as well as the advocates and counselors who work with them - describe RAFT as strained to the point of bursting, with applications backed up for months, and many languishing due to documentation problems, language barriers, and simple miscommunication. 

“You apply, and two or three months later you’re still wondering what’s going on,” said Akola Krishnan, who helps lead a Malden mutual aid society and has worked with dozens of struggling renters looking for aid. “It’s all a mess.” 

Part of the trouble, say people familiar with the program, is that RAFT was built for a different time. 

Designed to help tenants with a short-term loss of income stave off homelessness, the program has long required extensive documentation — from pay stubs to birth certificates for everyone in the household. Caseworkers might spend weeks going back and forth with tenants and landlords, gathering the needed paperwork. Now demand has dramatically increased, and renters are tapping into RAFT both to pay off back rent and to secure their apartments for months to come. 

“We need two things,” said Stefanie Coxe, executive director of the Regional Housing Network of Massachusetts, which represents the agencies that manage RAFT. “We need the resources to staff up to pandemic-level demand. And we need to streamline the process.” 

The state says it’s trying to do that by reducing paperwork. For instance, the program now allows applicants to provide Social Security numbers, instead of producing their actual cards, and soon will allow them to simply testify they are out of work, and then use state data — instead of pay stubs or a letter from their former employer — to verify that. Baker is providing $6.5 million to hire housing counselors, and has increased the annual cap on how much a landlord can receive to $10,000, from $4,000 — contingent on a promise not to evict for six months. 

Many in the housing industry doubt the $100 million Baker has put toward the RAFT program will be enough. As the eviction moratorium drew to an end, tenant and landlord advocates jointly called for $175 million, pointing to a recent report by the Metropolitan Area Planning Council estimating a $40 million gap each month between what laid-off workers statewide collect in unemployment and what they owe in rent. Other studies have warned of the potential for tens of thousands of evictions in the coming months. 

“So many people are thinking that this is going to be the lifeline,” said Helen Matthews, spokesperson for tenant advocacy group City Life/Vida Urbana. “There’s no way it’s going to be anywhere near what we need.” And that’s if people can even access it. 

For more on RAFT Strains and Demand see the full Boston Globe article.  

Evictions

As noted above, tenants who qualify for protection under the CDC Moratorium (see beginning of article for eligibility) should officially claim that protection by presenting a letter to their landlord. If tenants officially claim within 30 days that the pandemic changed their financial status (a layoff or reduced hours) and caused them to fall behind on their rent, they may be able seek a stay of an eviction until the end of December. The case will likely still continue in court, but if eligible, should prevent the final eviction. The CDC issued a guidance on October 9 clarifying its moratorium after lawsuits from landlords were filed. The guidance said the moratorium “does not preclude a landlord from challenging the truthfulness of a tenant’s declaration in any state or municipal court.” “It only applies those very last acts of an eviction process. The removal of the tenant,” said Michalakes. The federal ban allows for landlords to send a notice to quit, allows the court process to play out, only stopping short of allowing a judge to issue an execution for removal. 

The 11,000-plus pending cases that were filed before the mid-April ban will now start moving forward in the state’s housing courts. A large chunk of those pending cases are so far along in the legal process that the landlords will simply obtain from the courts execution notices, which allow constables or sheriffs to physically remove a tenant and their belongings from their apartments (unless the tenant gives the landlord the CDC moratorium declaration). 

Landlords can also begin the eviction process by sending a 14-day notice to quit to tenants they wish to evict for nonpayment of rent. After a tenant doesn’t reply to a notice to quit or declines to move, the landlord can then serve them with a summons for a court date. If mediation isn’t successful within two weeks, court proceedings can proceed. In 2019, it took 20 days, on average, for an eviction to play out after that point. 

Advocacy tip: tenants who receive the first letter in the eviction process, called the “notice to quit’ often mistakenly think this is the eviction itself and they have to leave by the date on the letter. Advocates can help to identify if this is a “notice to quit” and, if so, explain, it is just the first stage in the process and is not the same as an order from a judge that comes at the end of eviction proceedings. 

The section above was adapted from, and for more information see, the full Commonwealth Magazine article.

Eviction Process Explainer

WBUR's Meghan Kelly put together this explainer on how the eviction process works, and what rights you have. They include: 

  • Before things get to the point of eviction, remember that there are programs in place to help you if you're struggling to pay rent. Learn more. 
  • If you've exhausted all your rental relief options, you can apply for relief under the federal moratorium (CDC moratorium, through December 31). That that means filling out this form and giving to your landlord.
  • The first step landlords must take to evict you is to give you a "notice to quit," which has to give a reason for why you're being asked to leave. That reason has to be legal. Many people mistakenly believe the notice to quit is a court order telling them to move out. That's not true — it's literally just a notice that the landlord is starting the process for a specific reason. 
  • If that reason is missing rent payments, you can end the process by paying what you owe before the deadline (there are different deadlines depending on whether you have a lease or an at-will tenancy. Meghan has more on that in her post).
  • Next, the landlord has to go to court to file a complaint and issue a summary process summons, AKA an eviction summons. You have an opportunity to respond in writing and will have a court date. Don't skip court; you could automatically lose the case if you do. 
  • If you do get evicted, you have 10 days to appeal. But if you lose the appeal, you have just 48 hours to leave. The landlord has to pay to remove and store your stuff for up to three months; after that, you're on the hook for storage costs.

Read Meghan's full explainer on how the eviction process works.

This section is adapted from The Pandemic Continues But The Eviction Moratorium Is Ending, WBUR | Coronavirus Update, October 15, 2020

Courts Gear Up for Eviction Crush

In preparation for an influx of eviction cases, housing courts across Massachusetts are gearing up to make the process more accessible with translators, special days set aside for people who speak different languages, and in some courts, computer setups for people who can’t Zoom from home. 

The court has 40 staff interpreters ready for in-person, remote phone, and video conferencing and 65 per diem interpreters. Courts will pre-select two days a week where they will hear cases in a specific language (Spanish, Portuguese, Haitian, Cape Verdean, and Vietnamese being the top-five most needed) in order to streamline scheduling. Retired judges are also being brought back to ease the caseload. 

For tenants without access to computers, the courts in Brockton, Chelsea, and Worcester are setting up special Zoom rooms where participants can use computers and phones to take part in court proceedings. The computer stations – only about two or three per court – will be socially distanced and participants will be required to wear masks. 

-See the full Commonwealth magazine article: https://commonwealthmagazine.org/housing/courts-gear-up-for-eviction-crush/

Eviction Defense

Low-income tenants in need help in the eviction process? 

Refer to local legal service agency: www.masslegalservices.org/FindLegalAid 

If unable to access legal service: MADE: Massachusetts Defense for Eviction 

MADE is a free guided interview tool to help Massachusetts tenants defend against an eviction in court. After using the online interview, an answer and other pleadings are generated that the tenant can then file in court. The tool also includes videos and educational links about evictions. MADE is intended to be used after a Massachusetts tenant has received a summons and complaint.

 


The Scramble for Space to Shelter Homeless 

Homeless service providers in Massachusetts are scrambling to make sure they have enough space to shelter people and provide protection against the coronavirus as winter approaches. 

Shelter capacity has been limited because shelters have spaced beds at least six feet apart to comply with CDC guidelines. 

In recent years, Boston has sheltered 97% to 98% of its homeless population. In winter, shelters have been overflowing with people sleeping on mats. 

But in the pandemic, the percentage of people staying on the streets has risen. That's both because of the shelter capacity issue and because more people are choosing the streets over shelter out of fear of contracting the coronavirus. 

To that end, the city and organizations that serve people who are homeless have secured four additional shelter sites for the winter said Sheila Dillon, the city of Boston's housing chief and director of neighborhood development. 

The four new sites will add 200 emergency shelter beds to the city's current COVID-limited capacity of 1,064, according to city officials. The facilities will be paid for with a mix of state funds, federal CARES Act money, and private donations. 

City leaders won't reveal the locations of the winter shelters, saying paperwork is still being finalized. Two will serve adults; the other two will be for teens and young adults. One is an upper floor of an existing shelter. Another is a hotel that's been under-utilized during the pandemic, Dillon said. 

"The locations are scattered throughout Boston. They are not concentrated in any one neighborhood," she said. "And we have been very intentional not to put any more strain on the South End or the Mass-Cass area." 

That's the area around Mass. Ave and Melnea Cass Boulevard, which already houses homelessness- and addiction-related services and has been hit hard by the opioid epidemic. 

But even with the 200 additional shelter beds, the city faces a shortfall. Boston officials say to make up the difference, they're working with their nonprofit partners to try to house 150 people in apartments and rooming houses before the coldest weather hits. And they're relying on the state to help create additional shelter space around Massachusetts to lessen the strain. 

One place that's happening is Worcester, which says it's already secured space for an additional 50 to 75 people experiencing homelessness over the winter. In Lowell, officials said they're short that many beds for winter but are working on adding to the supply. 

'The System ... Is Still Going To Be Short' 

Joyce Tavon is senior director of policy and programs for the advocacy organization Massachusetts Housing and Shelter Alliance. She said she's concerned about a shortage of shelter beds based on what she's heard from DHCD. 

"That the system right now, even with the beds about to be added ... is still going to be short 800 beds this winter," Tavon said. "I mean, we know folks are working diligently to add more beds and reduce that gap. But it is not clear how many are actually going to be added." 

And, Tavon said, it's not clear where those beds will be. 

The largest day shelter in Boston, St. Francis House, hasn't been sending people away. The shelter's president and CEO, Karen LaFrazia, wonders how long that can last. "We've opened up spaces in the building to accommodate more people coming in," LaFrazia said. "But but at some point, we are going to be in a real dilemma." 

There's spread-out seating for only 125 people. St. Francis House currently serves about 300 clients over the course of an average day. They tend to take a shower, see their case manager or doctor, grab a boxed meal and go, LaFrazia said. 

"But we know what's going to happen," she added. "It's not going to be nice out and people aren't going to want to leave. So those 300 people, even if we stayed at 300 people, they will want to and need to be in our building for longer amounts of time. And that's when the problem's gonna be most significant." 

- See the full WBUR story.

 


Last Minute Voting for Inpatients and Voting Rights on Election Day

Last Minute Voting for Inpatients and Those Under Quarantine 

Registered voters who have been admitted to a healthcare facility or instructed to quarantine in your home within 1 week of the election, may use the absentee ballot application to designate someone of your choice to deliver a ballot to you. 

Note this requires multiple trips back and forth to the hospital and local election office. The person you designate to deliver your ballot will need to bring the signed application to your local election office, pick up your absentee ballot, bring it to you, and return it for you by the close of polls on Election Day. Emergency ballots may be requested up until the close of polls.

Absentee ballot application (English) and Spanish version 

Voting Rights on Election Day 

Vote.org also has a guide that outlines your voting rights.  

What to Do if You're Told You're Not on the Voter Roll

  • Confirm that you are registered to vote. 
  • Confirm that you are at the right polling place.  
  • If you are registered and at the right site don’t leave! Call the Election Protection hotline at 1-866-687-8683 and ask for help voting. 
  • Did you recently move? If so, you may still be registered where you used to live. Check with a poll worker to see if you can update your registration and vote a regular ballot where you are. Otherwise, you may need to vote at your old polling location or at a central polling place. 

Provisional Ballots & When to Use Them 

If possible, try not to cast a provisional ballot. Provisional ballots are, in essence, back up votes. These ballots are supposed to be counted when the eligibility of the voter is confirmed, however, it can be difficult in some states to find out if that has happened. In 27 states, if you cast a provisional ballot at the wrong polling location, your vote will not be counted.

 But if you must vote by provisional ballot as a last resort: 

  • Ask for written instructions about what you must do to ensure the provisional ballot will be counted. 
  •  Ask for a phone number you can call to confirm if your vote was counted.

 More at: https://www.vote.org/election-protection/ (Retrieved 9/29/20)

 Additional Information and resources

  •  Information on MA provisional ballots: https://www.sec.state.ma.us/ele/eleprovisionalballots/provisionalballotsidx.htm
  •  Threats, intimidation, being turned away from the polls? If you are registered and at the right site don’t leave! 
    •  If you feel that your right to vote has been violated in any way, call the Secretary of the Commonwealth's Elections Division at 1-800-462-VOTE (8683). 
    • National Resources: see the election protection website: https://www.vote.org/election-protection/ or call the Election Protection hotline at 1-866-687-8683 and ask for help voting. 
  •  Additional helplines and language lines: 
    •  866-OUR-VOTE (administered by the Lawyers’ Committee for Civil Rights Under Law) 
    • 888-Ve-Y-Vota (Spanish/English) – administered by the NALEO Educational Fund 
    •  844-Yalla-US (Arabic/English) – administered by the Arab American Institute, 
    • 888-API-VOTE (English, Mandarin, Cantonese, Korean, Vietnamese, Tagalog, Urdu, Hindi, and Bengali) – administered by APIAVote and Asian Americans Advancing Justice-AAJC.

 


 

It’s Fuel Assistance Season 

With colder weather upon us, agencies that administer the Low-Income Home Energy Assistance Program (LIHEAP) will start accepting new applications on November 2nd. See the fiscal year 2021 Income Eligibility and Benefit Levels chart. 

For more information and find the Fuel Assistance agencies serving Massachusetts please access the Fuel Assistance Brochure: Fuel Assistance Program Brochure for the 2020- 2021 Heating Season.

 


 

State Launching $115M Program to Boost Small Business- Early Nov Deadline 

Looking to further boost an economy that has added back tens of thousands of jobs since April but has a long way to climb out of the hole dug by the pandemic, Gov. Charlie Baker rolled out a multi-pronged strategy Thursday to infuse small businesses and workforce training programs with new money to cover payroll, rent, protective equipment and other expenses. 

The economic stimulus strategy comes as Baker and Beacon Hill Democrats continue to criticize and wait for Congress to deliver additional relief, aid that the governor reiterated Thursday is still needed. 

"To be clear, there's no substitute for the size and scope that a federal aid package could deliver. But that doesn't seem to be in the offing and we certainly don't believe that we can wait," Baker said at a State House press conference, where he also nudged the Legislature to finalize a $275 million borrowing bill that would invest in affordable housing, tourism and other economic development needs. 

The newest component of Baker's plan, he said, is $115 million in initiatives that include a $50.8 million grant program for small businesses who have been hit the hardest by the COVID-19 pandemic. Baker said the grants would be made available quickly - officials described a three-week application period - to support small businesses hurt by the pandemic, train workers in growth areas like manufacturing, subsidize internet for low-income residents and support community efforts to create new opportunities for commerce. 

Some business groups, like the Greater Boston Chamber of Commerce, were already encouraging members to apply quickly, though Baker said the money would be more targeted than prior investments, and not dispersed first come first serve. The grants will be made available through the Massachusetts Capital Growth Corp., and businesses with 50 or fewer employees will be eligible to receive up to $75,000 or up to three months of supported expenses for employee payroll and benefit costs, mortgage interest, rent, utilities and interest on other debt obligations. 

Businesses with five or fewer employees may access up to $25,000 to cover business costs like rent, staffing, and utilities, or to purchase personal protection equipment. 

The recovery plan announced this month by Baker has a lot of moving parts, and there are categories to help small business owners, the unemployed, landlords, renters and more. Some of the funding is new, while other parts of it come from existing programs. 

Mass Growth Capital Grants Details 

  • If you run a business with 5-50 workers, you can receive up to $75,000 or three months of expenses. If you have a business with five or fewer workers, you're eligible for $25,000.
  • The state will prioritize aid to business that haven't been able to open, with preferences to those owned by women, veterans and minorities. This is not first-come first-served
  • You can check eligibility and apply here.
  • Deadline: noon on 11/12/20
A new pot of $25 million announced Thursday for workforce supports included $10.4 million to expand partnerships with large employers and align job training and employment pathways, $9.2 million to subsidize internet for low-income residents and expand broadband hotspots in underserved communities, $3.2 million to connect unemployment benefit recipients with MassHire job search supports, $2 million to buy a standardized virtual manufacturing job training program, and $300,000 to augment the governor's budget request of $8.4 million for career technical institutes.

- See the full WBUR story.

 


 

Deadline to Register for Economic Impact Payment Further Extended 

The IRS announced that it is extending the deadline for low-income people and others who are not required to file a tax return to submit their information in order to receive an Economic Impact Payment. The new deadline to register is 3pm on November 21, 2020. Those who are eligible and have not yet received a stimulus payment can use the Non-Filers tool on IRS.gov to enter their information. 

This deadline differs from the one for Social Security and SSI beneficiaries to claim the $500 per child dependent payments; that deadline passed on September 30. However, there are still millions of eligible individuals who have not yet received their $1,200 payments. The IRS recently mailed out letters to almost  9 million people who may be eligible for, but have not received, an Economic Impact Payment. 

 Those eligible individuals who do not submit their information before the November 21st deadline will have to wait until next year to receive their payment by filing a 2020 tax return. 

 - From Justice in Aging, October 9, 2020

 


 

Reminder – SNAP Work Rules Are Suspended During Pandemic, Those Cut-Off Can Reapply, and ABAWD Lawsuit Settlement

Reminder that the ABAWD time limit and work rules are suspended due to the pandemic (and will continue to be suspended for a while). Anyone cut off in the past due to the time limit should re-apply for SNAP! See MLRI fliers here. 

 ABAWD Settlement 

Since 2016 MLRI has been raising concerns with DTA about the termination notice that DTA sent to ABAWDs who lost SNAP due to the time limit (ABAWDs are the childless non-disabled adults subject to 3 month time limit/work rules). In July 2019 MLRI filed a lawsuit, Wright v. DTA, challenging DTA's policy of terminating ABAWDs' SNAP benefits at the end of the 3 months without sending a notice of termination 10 days in advance of the termination. 

We have settled the lawsuit and DTA will soon mail out a Notice of Settlement to about 25,500 class members. Class members are all ABAWDs who were cut off from SNAP due to the time limit between April 2016 and July 2019. As part of the settlement, DTA has agreed to: 

  1. Issue 1 month of back SNAP benefits to all class members - we estimate this will total about $4.5 million in back SNAP benefits! 
  2. Invite all class members to re-apply for SNAP (if they aren't already getting SNAP) as the SNAP work rules are currently waived due to the pandemic 
  3. Use an improved termination notice in the future if the work rules go back into effect 

We will let the Coalition know when the back benefits will be issued; it will not be until after the judge approves the settlement. In the meantime, class members have a right to oppose the settlement if they don't agree with any part of the settlement. The point of the Notice of Settlement is to inform class members about what is going on, and their right to oppose it if they wish (for example, because they don't think 1 month of back SNAP is enough). 

You can read more about the settlement by reading the Notice of Settlement posted on Mass.gov here in English and Spanish. You can also see more on MLRI's website about the lawsuit: Masslegalhelp.org/SNAPtimelimit 

Clients may reach out to advocates with questions about the Notice of Settlement. If they do, please connect them to MLRI! Advocates can contact Vicky Negus directly, or email ABAWD@mlri.org 

- From Victoria Negus, MLRI, October 9, 2020

 


 

SNAP Cost of Living Adjustment

As of October 1, maximum SNAP grants increased about 5%, and there were some other changes to the SNAP math (increased shelter cap, etc). For households of 1-5, the SNAP grant amounts are now: 

 Household Size  Maximum monthly SNAP grant
 1  $204
 2  $374
 3  $535
 4  $680
 5  $807

Many households will see a change in their regular benefit issuance amount for October. There are currently COVID supplement payments that bring those normally ineligible for the maximum monthly grant up maximum. Those supplements are expected to be distributed in early November. 

See MLRI's revised excel SNAP calculator and 1 page SNAP math worksheet. 

Click the following links for updated "SNAP at a glance" charts for seniors/persons with disabilities, working families, and those receiving unemployment. This increase is tied to an annual Cost of Living Adjustment - it is not tied to an increase in food prices or need during COVID-19.

- From Victoria Negus, MLRI, October 1, 2020 

 


 

New Law Will Make 988 the National Suicide Hotline Number 

Across the United States, 911 is the number to call in the case of emergencies, and 211 is the number for local community services. Now, under a bill co-written by Rep. Seth Moulton and signed into law Saturday by President Donald Trump, Americans will have a new three-digit hotline, 988, to call if they have questions or concerns about the mental health of a loved one — or their own. 

The bipartisan bill — introduced last year by the Massachusetts Democrat and Rep. Chris Stewart, a Utah Republican — unifies the country’s existing suicide prevention and mental health hotlines run by local crisis centers under the simple 988 number. 

According to the National Institutes of Health, suicide is the second-leading cause of death for individuals between the ages of 10 and 34, and the fourth-leading cause among those between 35 and 54. 

“When your house is on fire, you can get help by calling 9-1-1,” Moulton said in a statement. “A year-and-a-half ago, we set a goal to make it just as easy to get help in a mental health emergency. Today we finished the job and made 988 the national number for mental health emergencies.

Callers will still be able to reach the national suicide prevention line at the existing 10-digit number: 1-800-273-8255

But mental health advocates say the simplified number will make it easier for “millions” of Americans to access live-saving resources, particularly amid spiking reports of mental health struggles amid the COVID-19 pandemic. According to a survey by the Centers for Disease Control and Prevention this summer, nearly 11 percent of respondents said they seriously considered suicide in the previous 30 days, which was more than double the rate in 2018. Younger adults, people of color, and essential workers also reported disproportionately high mental health issues, from anxiety to depression to suicide ideation. 

 The enactment of the law comes after the Federal Communications Commission approved a rule in July requiring all phone service providers to direct 988 calls to the existing National Suicide Prevention Lifeline by July 16, 2022. According to Moulton’s office, the number could be ready sooner in many locations. In the meantime, individuals are encouraged to continue to use the 1-800-273-8255 suicide prevention number until the new 988 hotline is fully implemented. 

The new law signed Saturday cements the 2022 deadline and provides permission to states to fund the often under-resourced suicide hotline similar to how they fund 911 call centers (for example, Massachusetts levies a small monthly surcharge on telephone bills). 

Additionally, the new law directs federal agencies to develop a strategy to help National Suicide Prevention Lifeline counselors provide competent, specialized services fo high-risk populations, including LGBTQ youth, minorities, and rural individuals. 

 The 988 number is now the seventh three-digit number that the FCC has assigned for national use. According to the commission, the other numbers are 211 for community information and referral services; 311 for non-emergency police services; 511 for traveler information services; 711 for the Telecommunications Relay Service; 811 for notice of excavation activities; and 911 for emergencies. 

 - See the full Boston.com article

 


 

Social Security Administration In-Person Appointments Update

On October 22, 2020, the Social Security Administration (SSA) revised the information available on its COVID-19 webpage about who is eligible for an in-person appointment while its local offices generally remain closed to the public due to the pandemic. They divide their instructions into: 1) Those who need help with their benefits; and 2) Those who need help with a Social Security number (SSN). 

For those who need help with their benefits  

Generally, SSA will schedule an in-person appointment for those “in dire need situations.” SSA defines a dire need situation as when an individual: 

  • Is without food or shelter, including utilities, or is without medical care or coverage and needs to apply for or reinstate benefits from SSA; or 
  • Currently receives benefits from SSA and has an urgent need for payment to meet expenses for food, shelter, or medical treatment, and the individual cannot receive a payment from SSA electronically.

For those who need help with a Social Security number  

SSA is prioritizing requests for in-person SSN services for: 

  • Individuals age 12 or older applying for their first SSN card. 
  • Individuals who need to update or correct their SSN information (such as their name, date of birth, or citizenship) to obtain income, resources, or medical care or coverage, or other services or benefits (for example filing a tax return, applying for housing, or seeking an Economic Impact Payment). 

SSA encourages those who don’t fit into one of these priority situations to request a replacement SSN card through an online my Social Security account, or by mailing an application for a Social Security card (Form SS-5) to their local office, along with original documents to prove their identity, with the assurance that these documents will be mailed back to the individual. 

However, SSA concedes that since there are “delays processing mail-in SSN card applications, it may take us between two and four weeks to process the application and return the evidence.” In many states, individuals will be punished if they are found to be driving without having their driver’s license on their person, and the law prohibits immigrants from having their immigration documents out of their possession. SSA’s Program Operations Manual System (POMS) contains this warning on the requirements for replacing an SSN card: 

CAUTION: Never ask a noncitizen applicant to mail his or her immigration document to SSA. Under the law, noncitizens 18 years of age or older in the U.S. must have immigration documentation in their possession at all times. If they do not, they are subject to fine and/or imprisonment. 

- From Update on In-Person Appointments at SSA Local Offices, Justice in Aging, October 28, 2020

 


 

Social Security Benefits Increase in 2021 

Approximately 70 million Americans will see a 1.3 percent increase in their Social Security benefits and Supplemental Security Income (SSI) payments in 2021. Federal benefit rates increase when the cost-of-living rises, as measured by the Department of Labor’s Consumer Price Index (CPI-W).

We will mail all the cost-of-living adjustment (COLA) notices throughout the month of December to retirement, survivors, and disability beneficiaries, SSI recipients, and representative payees. But, if you want to know your new benefit amount sooner, you can securely obtain the Social Security COLA notice online using the Message Center in your my Social Security account. You can access this information in early December prior to the mailed notice.

You can find more information about the 2021 COLA here.

- See the full SSA blog post.

 


 

Recipients of Lowest MA Unemployment Will Receive Bonus

As many as 17,000 unemployed Massachusetts residents could become eligible for thousands of dollars in additional unemployment benefits under legislation that swept through the House and Senate and was signed by Gov. Charlie Baker this month to provide relief to residents who didn’t initially qualify for the federal Lost Wages Assistance program.

The federal program ran in Massachusetts for six weeks from the end of July through the first week in September, but in order to qualify for the additional $300 in weekly unemployment benefits a claimant had to be receiving at least $100 in weekly state benefits.

The bill passed by the Legislature and signed by Governor Baker this month increased the minimum benefit for any unemployment insurance beneficiary to $100 for the week ending Aug. 1 through the week ending Sept. 5. Sen. Pat Jehlen of Somerville, who filed one version of the bill along with her Labor Committee co-chair Rep. Stephan Hay, said for one of her constituents a state investment of $12 would yield nearly $2,000 in federal funds.

“Overall, state investment will bring an estimated 10-times return. This is thirty-one million dollars that people in Massachusetts can use for rent, for food, for other necessities. It will benefit them and local businesses. We can be absolutely sure they will spend it locally and immediately,” Jehlen said. 

It’s unclear exactly when those earning the lowest benefit will get the added boost, but Baker’s office indicated the funds are available through the U.S. Department of Labor to support the payments. 

The administration is in communication with federal officials and a spokesman said more updates would be available soon.

- See the full Commonwealth article and the full Boston Herald article.

 

Program Highlights

Chelsea Collaborative Now “La Colaborativa” and Broadens Service Area

In an announcement to supporters this month, Gladys Vega, Executive Director of the Chelsea Collaborative announced they are officially changing their name to La Colaborativa in “an embrace and affirmation of our Latinx roots and our commitment to serve, protect, celebrate, and uplift Latinx communities in Massachusetts and beyond.”

More from the announcement (bold added):

Second, we are expanding our geographic focus beyond our beloved city of Chelsea, to serve residents throughout the region in communities like East Boston, Everett, Malden, and Revere. We know that the housing and job markets often require our community members to relocate outside of Chelsea. Immigrants throughout the region are unified by similar challenges that La Colaborativa can help address.

City limits will not prevent us from staying connected with our growing base of members, providing services where there are needs, and uniting and empowering this large and ever-growing base of immigrant leaders in Massachusetts. While our home base is Chelsea, we are excited and proud to make this shift and open our doors to immigrants across the region with expanded programming and social justice organizing.

See the full community letter.

- Thanks to Laura Maslow-Armand for sharing this update.

 


 

Help for Pet Owners Facing Eviction

The Animal Rescue League of Boston has a plan to help owners and pets reunite after tough times. Residents who are evicted from their homes will be able to register their pets for temporary housing assistance. The program is free of charge.

Predicting an influx of pet owners at risk of losing housing once the moratorium expired, the rescue league imagined ways to keep owners and their animals together through the pandemic.

Instead of bringing animals space to shelters, the rescue league set up a program in which volunteer foster families will take care of a pet for up to four months. During that time, the pet’s owners will be allowed to schedule confidential bi-weekly check-ins with their pet.

Any owners experiencing housing instability are eligible for the program, which will be determined during a phone call to the ARL’s admissions office. Once the owner is approved and their pet is brought to the designated shelter, the pet will undergo basic medical screenings for two days. Pets will also undergo a behavioral screening to ensure they are matched with the ideal foster family.

The program is open to residents who live in the eastern part of the state, including the Cape and Islands.

- See the full Boston Globe article.

 

 


 

Cambridge Opens Public Showers as Housing Instability Grows

Two trailers opened for business this month in a parking lot in Harvard Square. The long white units, next to a Harvard computer lab and across from a Mexican food restaurant, include an amenity many of us take for granted: a hot shower.

“Poor and homeless people have always had trouble accessing hygiene facilities,” says First Church Shelter director Jim Stewart. “Following the onset of the pandemic, shelters were forced to de-congregate and there just hasn’t been access that people have counted on in the past.”

First Church Shelter will staff and assist with use of the 10 showers, two of which are wheelchair accessible. City Councillor Marc McGovern says Cambridge is spending $12,000 a month to rent the units. Installation, which includes water, sewer and electrical connections, cost about $10,000.

Cambridge rented port-a-potties early in the pandemic for people who had used bathrooms in libraries, restaurants or other buildings that shut down in March. McGovern says Cambridge started talking about opening showers in April, but finding the units, as well as a location that was large enough, handicap accessible, close to plumbing and electricity, was complicated. “It’s taken longer than anyone had hoped but I’m glad to see it’s happening,” he said.

McGovern says he doesn’t know of other free-standing showers in Massachusetts for people who are homeless. “We’re seeing more people living outdoors during COVID and places with showers have had to limit services” the National Coalition for the Homeless associate director Megan Hustings says. “The coming eviction crisis — so many people out of work — all of these things compound to create much more need for shelter and hygiene services.”

There have been concerns about people overdosing, undetected, in public bathrooms and showers. Stewart says his staff will make sure clients have privacy while staying safe.

Harvard University is loaning Cambridge the parking lot for this project.

The shower units are expected to remain in place at least through the end of the year. This week, the showers are open on weekdays from 1-4 p.m. The organizers say they will reassess in a few weeks, based on feedback, and adjust the hours if needed.

- See the full WBUR story.

 


 

Boston’s Double Up Food Bucks

Boston Double Up Food Bucks is a SNAP incentive program. You can get 50% off fresh fruits and vegetables at participating stores with your EBT card. Get a daily discount of up to $5 for spending $10 at participating stores. Use Double Up to bring home more fresh produce today!

The state reimburses the local stores that participate.

Currently there are 6 participating stores in Dorchester, Mattapan and Roxbury. See the flyers below for locations. The city is outreaching to recruit additional vendors.

Flyers:

FOOD BUCKS FLIER- ENGLISH (PDF)
FOOD BUCKS FLIER-SPANISH (PDF)

- Source and for more information: https://www.boston.gov/departments/food-access/boston-double-food-bucks

-Thanks to Kristen Risley for sharing (previously posted to the MGH Outreach and Resource Navigation Group email list)

 


 

Expanding Seniors Save Program Helps Seniors Replace Old Heating Systems

The Seniors Save program helps low-income seniors over the age of 60 replace old heating systems in their homes. Since the program launched in 2015, we’ve replaced more than 200 faulty heating systems throughout Boston’s neighborhoods.

We used to provide grants up to $3,500. Now, we’ve more than doubled that amount to $8,000.

Older residents living on fixed incomes can’t always afford important improvements to their homes. New, energy-efficient systems help prevent heating emergencies during cold weather. They also help reduce energy bills. Seniors are encouraged to take advantage of this program before the cold weather hits. To find out if you qualify, and to apply, go to Boston.gov/HomeCenter or call (617) 635-HOME

More About the Boston Home Center

The Boston Home Center helps Boston residents buy, improve, and keep their homes. We offer training, financial help and counseling to first-time homebuyers. We also guide and counsel families to help avoid foreclosure. The Home Center markets homes developed for income-eligible, first-time homebuyers. You can learn more about income eligibility online.

Additional programs:

Our call center is open. Have questions about our programs? Please call 617-635-4663 or email us at HomeCenter@boston.gov.

-Thanks to Kristen Risley for sharing (previously posted in part to MGH Outreach and Resource Navigation Group email list.)

 


 

Mystic Valley Elder Services’ TRIP Metro North Program- Mileage Stipend

Mystic Valley Elder Services (MVES) offers the TRIP Metro North program, a free program where seniors and adults living with disabilities can ride with friends, neighbors and certain relatives to wherever they need to go and MVES will provide mileage stipends to the driver. If you are 60 years or over, or an adult living with a disability and you don’t drive or can’t use or access public transportation, TRIP may help you get to stores, medical appointments and any social activities you enjoy.

TRIP is easy. Each month, participants make arrangements with friends, neighbors, or other individuals interested in helping out — including relatives — to drive them where they need to go. (Unfortunately children and spouses are ineligible as volunteer stipend drivers.)

The program is one-on-one, and riders and drivers make their own schedules. Together, they keep track of the mileage. At the end of the month after travel, TRIP sends reimbursement for the driver. Participants may work with more than one driver, if that suits their needs. The program is about getting out, staying social and remaining independent.

There are many options to explore for getting where you need to go. Give us call to learn more about MVES’ transportation services, at 781-324-7705 and ask to speak to our Information and Referral Department. Source and for more information: https://www.mves.org/transportation-services-are-essential-for-those-dependent-on-it/

- Thanks to Melissa Alao for sharing this resource.

 


 

Lawrence Mayor Unveils $400K Child Care Fund

Lawrence Mayor Dan Rivera this month rolled out a $400,000 scholarship fund to help 200 children enroll in licensed daycare programs.

The fund is being created in partnership with The Community Group and several Lawrence-based child care providers licensed by the Department of Early Education and Care, he said.

It is earmarked for "those who do not qualify for childcare subsidies but are under a certain income amount."

Rivera personally knows the expense of daycare. With two young children of his own, he said monthly daycare costs are more expensive than his mortgage payment. "We have seen families in difficult situations these past couple of months; being put in a position of having to decide between losing their jobs, leaving their kids home alone or placing them with unlicensed providers," Rivera said.

Children will be placed in structured environments where they will have access to the internet, adults familiar with remote learning plans, nutritious food, physical activity, outdoor play, and safe, socially distanced interactions with peers, according the plan.

Interested families can email scholarship@childcarecircuit.org or call (978) 722-2593, (978) 722-2534 or (978) 722-2560.

More details on the scholarship fund can be found at childcarecircuit.org or thecommunitygroupinc.org.

- See the full Eagle Tribune article.

- A version of this article was sent previously to the MGH Outreach and Resource Navigation Group email distribution list.

 

 

Health Care Coverage

 

CMS Releases Medicare Advantage and Part D Cost-Sharing Information for 2021

Medicare’s annual Fall Open Enrollment Period (OEP) occurs from October 15 to December 7. During this time, people with Medicare can make unrestricted changes to their coverage, such as switching Part D prescription drug plans or between Original Medicare and Medicare Advantage. Final coverage updates take effect on January 1.

To allow people to preview their options before the Fall OEP begins, the Centers for Medicare & Medicaid Services (CMS) recently posted benefit and cost-sharing information for 2021 Medicare Advantage and Part D prescription drug plans on Medicare.gov.

This year, people with Medicare and enrollment counselors will have a lot to wade through, as insurers continue to expand plan offerings. There are also new initiatives taking effect in 2021 that may impact coverage decisions. For example, a new program will offer lower monthly insulin payments for some people with Medicare. It is voluntary for drug plans, so beneficiaries should use the Medicare Plan Finder or contact a drug plan directly to learn if it is participating. At the same time, the COVID-19 pandemic continues to put many people with Medicare at risk. Public health guidelines will likely restrict in-person enrollment counseling, potentially making it more difficult for people to find the best coverage for their unique circumstances—at a time when they need it most.

These decisions and considerations can be daunting. Read more for some tried and true Fall OEP advice from Medicare Rights.

Here is some tried and true Fall Open Enrollment advice from Medicare Rights:

  • If you have Original Medicare and a supplemental plan (often called a Medigap) and are happy with your coverage, you do not need to make a change. 
  • If you have a Medicare Advantage or Part D plan, you should review your coverage options even if you are happy with your current coverage, because plans change their costs and benefits every year. 
  • Read your Annual Notice of Change (ANOC), which you should have received from your plan by September 30. It will list the changes in your plan, such as the premium and copays, and will compare the benefits in 2021 with those in 2020. Your plan may send your ANOC in an email rather than a hard copy in the mail. If you would like a hard copy, call your plan to request one be mailed to you. 
  • Your current plan may not be your best choice for 2021. Shop around to find a plan that best meets your needs and makes the most financial sense to you. 
  •  Wondering what type of coverage is best for you? Visit Medicare Interactive to learn about the differences between Original Medicare and Medicare Advantage. 
  •  If you need help, call your State Health Insurance Assistance Program (SHIP) (SHINE in MA) and/or 1-800-MEDICARE. Medicare Rights will also be helping people navigate their options. You can reach our National Helpline counselors at 800-333-4114.

Visit Medicare.gov to start your plan finder any time between October 15 and December 7. 

Source and for more information: https://www.medicarerights.org/medicare-watch/2020/10/08/cms-releases-medicare-advantage-and-part-d-cost-sharing-information-for-2021

 

Policy & Social Issues

 

MA Foster Parents Could be First in Nation to Unionize

Massachusetts could become home to the first union to successfully represent foster parents. SEIU 509 has announced plans to unionize thousands of foster parents across the state.

Union officials say that while foster parents provide nurturing and compassion, they also require the critical skills needed to guide a child who has experienced abuse and neglect.

“These families are undervalued and under resourced,” Peter MacKinnon, president of SEIU 509 said in a press release. “Like every essential worker, foster parents need a collective voice at the table fighting for them.”

MacKinnon said the need for union representation for foster parents is even more critical given the ongoing pandemic.

Besides remote learning and technology demands, foster parents must safely navigate COVID-19 behavioral and mental health care, virtual and in-person visits with biological parents, and appointments with social workers to ensure children are getting the support they need.

Many foster parents are also taking on the added cost of personal protective equipment and sanitation materials to keep their homes safe and healthy, he said.

SEIU 509 and hundreds of foster parents are planning to deliver a series of COVID-19-related demands to Gov. Charlie Baker and members of his administration including: free and accessible testing and personal protective equipment; planning for what will happen if a foster parent, foster child, or biological parent is infected with coronavirus; and doubling the daily reimbursement for foster parents to cover expenses incurred while supporting their foster children.

- See the full Mass Live article.

 


 

As Many as 129,000 MA Immigrants May Refuse MassHealth over Public Charge Fear

Up to 129,000 Massachusetts residents might shy away from MassHealth and thousands could avoid food assistance — despite massive layoffs during the coronavirus pandemic — out of fear that those benefits could affect their or a loved one’s immigration status in the future, according to a new report.

The Massachusetts Medicaid Policy Institute and UMass Medical School’s Commonwealth Medicine projects in a report published Tuesday that thousands are likely to deny themselves these benefits for fear of the expanded “public charge” rule that took effect earlier this year — not because the rule would apply to them, but because they erroneously believe or still fear the rule could affect them or their families somehow.

The report projects between 55,000 and 129,000 residents will likely unenroll from or avoid enrolling in MassHealth as part of a “chilling effect" expected from the updated rule. The report projects between 27,000 and 63,000 residents will live in households that will shy away from the Supplemental Nutrition Assistance Program (SNAP).

This is in a state with at least 1.1 million foreign-born residents and an estimated 500,000 non-citizens with varying levels of immigration status (some estimates suggest the number is higher). “This analysis demonstrates that many more people to whom this policy change does not apply will be harmed as well, given their fear that it might apply to them, and the result will be poorer health, more food insecurity and greater stress for many in the commonwealth," said Audrey Shelto, president of the Blue Cross Blue Shield of Massachusetts Foundation.

Months after the “public charge” rule first took effect, Natalicia Tracy hears the same question about public benefits and even recent COVID-19 relief programs.

“What they say is, ‘well, how do you know for sure those exemptions are going to be written on the application in the future?’” said Tracy, executive director of the Brazilian Women’s Worker Center in Boston. “'How do you know if Trump wins again he’s not going to use it against us?'”

Despite COVID-19, Gina Plata-Nino, a staff attorney for the Central West Justice Center of Community Legal Aid said the justice center has noticed Latinos, even U.S. citizens with immigrant relatives and green card holders are worried they could be affected by the “public charge” rule by using public benefits — even though the rule does not apply to them.

The report also breaks down the projected “chilling effect” on children, people with disabilities and the state economy.

An estimated 46,000 children could lose out on MassHealth coverage and up to 22,000 children could lack access to SNAP benefits in Massachusetts. The lack of health care and food assistance could be linked to health issues including mental health issues, asthma and other health concerns, according to the report.

The report also estimated up to 9,000 seniors could avoid MassHealth and up to 8,000 people with disabilities could avoid MassHealth. Thousands of these individuals are believed to live in a household at risk of shying away from SNAP benefits. Some pregnant mothers have also been flagged as at risk of losing out on SNAP benefits for which they’re eligible.

The financial impact is projected to hit both private health care providers and the commonwealth. Hospitals are at risk of losing $457 million a year, community health centers could lose millions in MassHealth revenue and stores could lose up to $85 million in revenue from SNAP benefits.

MassHealth could lose federal funding, which could lead to fewer jobs and resources for medical care. See a public charge factsheet/Infographic at: https://infogram.com/public-charge-1hke60jg00p125r

- See the full Mass Live article

 


 

Opinion: Trump’s executive order on Health Care is No Replacement for Obamacare

The Supreme Court is scheduled to hear oral arguments Nov. 10 in a case seeking to overturn the Affordable Care Act that brought insurance coverage to millions of Americans.

Meanwhile, Trump recently released his “America-First Healthcare Plan.” In it, the president claims significant achievements. He also outlines broad principles of his vision for the future of health care in America.

Over the past three years, the Trump administration has taken a number of steps to dismantle pieces of the ACA. And his recently introduced executive order lacks a number of key details and the legal grounds for enacting much of the proposal.

The two factors leave me — a health policy and politics scholar who has closely followed the Affordable Care Act — skeptical about the emergence of a meaningful replacement to the ACA that would expand insurance access should the Supreme Court invalidate the Obama administration’s signature achievement.

Trump’s moves on health care

President Trump campaigned and entered office with the pledge to “repeal and replace” the ACA. In his own words, there would be a “really great HealthCare Plan with far lower premiums (costs) & deductibles” right after the election.

Since 2016, Congress has made little headway besides eliminating the ACA’s penalty for not carrying insurance. This is the basis for the current lawsuit to be heard before the Supreme Court in November. The argument is that because Congress did away with the penalty, the individual mandate can no longer be constitutionally justified as a tax. As a result, the entire law should fall.

While Republicans have been unable to repeal the law, the Trump administration has taken a number of executive actions to limit its reach. In combination, these efforts have contributed to bringing the uninsured rate to 14% by 2019 from a low of 11% in 2016. This leaves millions of Americans without coverage and exposed to medical bills should they fall ill.

One of the major targets of the Trump administration has been reducing enrollment through the ACA’s marketplaces. Here, the administration shortened the periods in which people are allowed to purchase insurance and drastically reduced funding for individuals who help consumers enroll in coverage as well as advertising. It also withheld subsidies to support low-income individuals with out-of-pocket costs, which also caused problems to insurers offering plans to those people.

The administration has also worked to expand alternative insurance plans like so-called short-term, limited-duration health plans and association health plans. While these plans have lower premiums, they do not carry the consumer protections of the ACA like preexisting condition coverage. They also do not pay for prescription drugs or hospital stays. And unlike the ACA, they also require consumers to undergo a medical assessment before enrollment. Consumers may be charged higher premiums or rejected entirely based on their medical condition and age.

Regulations issued by the Trump administration have reduced access to reproductive care for women. The administration has also pushed states to implement work requirements for Medicaid beneficiaries and discourage immigrants from enrolling in Medicaid for fear of being denied permanent residency. As a result, thousands of individuals have become uninsured.

Even on one of the president’s favorite topics, reducing the cost of prescription drugs, numerous initiatives regarding generic drugs, drug importation and capping insulin prices for Medicare beneficiaries have done very little to reduce cost or improve access.

On one of the president’s other priorities, eliminating surprise bills for medical services that patients unexpectedly receive for care that they reasonably thought would be covered by their insurance, the administration’s actions have yet to have a meaningful effect.

Executive order

When it comes to Trump’s executive order, the topic that received the most public attention — the guarantee that “Americans with pre-existing conditions can obtain the insurance of their choice at affordable rates” — carries no legal weight nor clear explanation of how it would be achieved or funded.

More generally, after years of promising a detailed plan, the America-First Healthcare Plan focuses primarily on past actions. It also spends just 491 words on laying out a set of objectives — lower costs, better care and more choice — yet does not provide a mechanism or road map for how to implement them.

All this leads me to believe that if the ACA is overturned before the Supreme Court, the prospect of substantive replacement that seeks to expand care to more Americans is unlikely.

- See the full Market Watch article.