Healthcare in Massachusetts Despite being among the best in the nation, care is still out of reach for too many residents. From doctor visits to life-saving medicines, too many people don’t have access to the services they need when they need them. Fortunately, the House’s proposal, now under consideration by the Budget Committee, would provide significant cost savings to these residents statewide.
Physicians and patients recognize the urgent need to make healthcare more accessible and equitable. Physicians are well aware of the consequences of patients forgoing follow-up care and prescribed treatment because they cannot afford it, and consumers often rely on the coverage they can afford. Ask for help finding options. With costs rising across the board, we need to pursue more affordable coverage options for all federal residents.
It starts with getting everyone covered and staying insured. With states now reviewing eligibility for mass health for the first time since the pandemic, there’s a risk that people with too high incomes will lose coverage or end up on plans that are too expensive. To qualify for ConnectorCare, the state supplemental insurance program. It is more important than ever to ensure affordable coverage options for those who find themselves no longer eligible for MassHealth to ease the transition and keep national coverage rates at the highest levels.
Accessing affordable health insurance is also a matter of health equity. Despite high coverage, more than 40 percent of his residents reported challenges in receiving care, with black and Hispanic/Latino residents reporting more challenges in receiving care than white residents. more likely to report. According to one report, 75 percent of black adults and 68 percent of Hispanic/Latino adults in Massachusetts face care difficulties, compared with only 46 percent of white adults. In fact, the lack of affordable coverage options makes the disparity most pronounced for those beyond the ConnectorCare eligibility level.
A two-year exam program included in the House budget addresses these challenges by expanding ConnectorCare’s eligibility. Individuals and families earning up to 500 percent of the federal poverty level (approximately $73,000 per year for an individual) will be eligible for reduced premiums and coverage with minimal co-payments and deductibles on a trial basis. be able to join the It is estimated that between 47,000 and 70,000 Massachusetts residents are eligible for the new, more affordable premiums. By leveraging the savings from enhanced federal aid, the pilot will no longer require additional state funding.
The expansion will almost certainly help Debbie, who lives in Brookline and cares for her husband with Alzheimer’s. She has been on MassHealth for several years, but her husband’s social security income increased last year. And she now knows that because her MassHealth insurance coverage has ended, she will have to find insurance elsewhere. Unfortunately, Debbie’s income is slightly above her current eligibility for the state’s low-cost ConnectorCare program. Her only option is a plan that’s too expensive for her budget, with a monthly premium of over $300 and her $3,000 deductible. Debbie takes medication to manage her arthritis, elevated cholesterol, and high blood pressure, but worries about adding multiple copays and ending up with a more expensive plan.
Newton’s Arturo also experienced this challenge firsthand. The only health plan that he and his three family members can pay for has a $4,000 deductible for him, a $150 copay for doctor visits, and a $260 copay for blood tests. Such as, a large self-burden occurs. These costs make Arturo worried about whether he will be able to care for his family in the future.
Massachusetts doctors are so often sick with worry about patients like Debbie and Arturo that it has a negative impact on their health. When patients cannot afford the care they need, they often delay or abandon that care, leading to adverse health consequences that could have been avoided had they been able to access and afford the care they needed. increase.
For tens of thousands of Massachusetts residents like Debbie and Arturo, the ConnectorCare Expansion Pilot will make a big difference in their lives, giving them access to lower premiums and far less costly plans, giving them greater financial flexibility. No more worries. future care. We are close to crossing the finish line with this policy and hope this proposal will be included in the final meeting budget to help Massachusetts become more affordable for these health care consumers.
Massachusetts has a history of coming together to tackle big challenges. In this moment, it’s time we do it again to ensure everyone has access to the protection and care they need.
Amy Rosenthal is Executive Director of Health Care For All. Dr. Barbara Spivak is president of the Massachusetts Medical Society.
