All Publications

Understanding Legal Challenges to the Affordable Care Act: A Brief Review of Key Issues

This educational brief describes the key elements of the Affordable Care Act (ACA) and provides an overview of California v. Texas, a case currently before the U.S. Supreme Court that seeks to overturn the ACA. Also included in this brief is a discussion of recent relevant case history and how the arguments in California v. Texas build upon prior legal challenges to the ACA.

Potential Coverage and Federal Funding Losses for Massachusetts if California v. Texas Ultimately Overturns the Affordable Care Act

California v. Texas, a case currently before the U.S. Supreme Court, seeks to overturn the Affordable Care Act (ACA). The court is expected to begin hearing arguments on this case on November 10, 2020. A final ruling that overturns the ACA would have widespread implications, affecting every state in the nation.

Behavioral Health Urgent Care: A Vision for Massachusetts and Opportunities to Improve Access

Behavioral health urgent care services are a critical component of the broader behavioral health care delivery system. Developing and sustaining a robust set of behavioral health urgent care services across community-based settings will provide adults with more options for timely access to care and offer alternatives to emergency departments for treatment.

MassHealth: The Basics – Facts and Trends (October 2020)

This UPDATED (October 2020) edition of the MassHealth: The Basics chart pack provides new data on MassHealth enrollment and spending from the most recent state fiscal years available, as well as a high-level overview and status update on the state’s delivery system reform efforts. The 2020 chart pack features a summary of the many temporary policy and programmatic changes that MassHealth quickly implemented in response to the COVID-19 pandemic.

The Final Public Charge Admissibility Rule: Implications for Massachusetts

The revised federal public charge rule – which was finalized in August 2019 and took effect in Massachusetts in February 2020 – makes it harder for certain low- and moderate-income immigrants to obtain green cards or visas if they have applied for or enrolled in public benefits such as MassHealth or the Supplemental Nutritional Assistance Program (SNAP). This report describes the expected effects of the revised federal public charge rule on MassHealth and SNAP enrollment, and its downstream effects on the health of Massachusetts residents, health care providers, and the state’s economy.

Expanding Access to Behavioral Health Care in Massachusetts through Telehealth: Sustaining Progress Post-Pandemic

At the onset of the COVID-19 public health emergency, Massachusetts led the nation in rapidly deploying progressive policies to temporarily expand access to telehealth. These changes have enabled significant increases in adoption of telehealth, including telebehavioral health, for providers and consumers in a short period of time. Prior to COVID-19, utilization of telebehavioral health had not gained widespread spread traction in Massachusetts despite its potential as a means to dramatically improve access to behavioral health care services, particularly for vulnerable populations.

Summary of the Behavioral Health Provisions of Governor Baker’s 2019 Health Care Bill

On October 18, 2019, Governor Charlie Baker submitted House Bill 4134, An Act to Improve Health Care by Investing in Value, to the Massachusetts Legislature. The bill proposes a comprehensive set of policies designed to address barriers to behavioral health care access, including the establishment of a new system that would incentivize providers and health plans to spend more of their funds on primary care and behavioral health services while rebalancing spending in other areas.

Potential Coverage and Federal Funding Losses for Massachusetts if Texas v. United States Ultimately Overturns the Affordable Care Act

Texas v. United States, a case currently before the U.S. Court of Appeals for the Fifth Circuit, seeks to overturn the Affordable Care Act (ACA). The court’s decision in the case could be announced any day and the case may ultimately be decided by the Supreme Court. A final ruling that overturns the ACA would have widespread implications, affecting every state in the nation.

What to Know About ACOs: The Latest on MassHealth Accountable Care Organizations

This brief builds upon a July 2018 publication, What to Know About ACOs: An Introduction to Accountable Care Organizations, which was developed as a resource for stakeholders (i.e., providers, health care administrators, and policymakers) to help explain the key elements of MassHealth ACOs, including the three types of ACOs, who they serve, and the services they provide.

The Geography of Uninsurance in Massachusetts: An Update for 2013-2017

This brief and accompanying set of tables serve as an update to previously released reports on the geography of uninsurance in Massachusetts. Relying on newly released data for 2013-2017 from the American Community Survey (ACS), this brief uses three measures of uninsurance – uninsurance rate, number of uninsured, and concentration of uninsured – to identify high-uninsurance communities in the state.

MassHealth: The Basics – Facts and Trends (July 2019)

This UPDATED (July 2019) edition of the MassHealth: The Basics chart pack provides new data on MassHealth enrollment and spending from the most recent state fiscal years available, as well as a high-level overview and status update on the state’s delivery system reform efforts. The 2019 chart pack features a summary of the program’s impacts on access to care and health outcomes and new data highlighting the role of MassHealth in supporting the low-income workforce.

Fostering Effective Integration of Behavioral Health and Primary Care in Massachusetts: An Evaluation

In January 2016, the Blue Cross Blue Shield of Massachusetts Foundation undertook a three-year grant-funded initiative to expand access to integrated behavioral health (IBH) and primary care services in Massachusetts – Fostering Effective Integration (FEI). Grants were awarded to a diverse cohort of eight providers in the Commonwealth with experience in delivering IBH care. This report describes the findings of an evaluation conducted by John Snow, Inc. (JSI) from January 2016 to December 2018.

What is the Actual State Cost of MassHealth in 2019?

Among state budget items, MassHealth is well known as one of the largest spending categories, while its role as a significant source of federal revenue is often overlooked. This brief takes a look beyond the budget totals to help stakeholders better understand the actual state cost of MassHealth when factoring in the state and federal partnership that finances this program. In fiscal year (FY) 2019, the state projects it will spend approximately $16.7 billion on MassHealth. This total (or “gross” amount) is approximately 36 percent of total estimated state spending for FY 2019.

Faces of MassHealth: Portrait of a Diverse Population

This collection of materials goes beyond the topline statistics often used to characterize those served by MassHealth in order to paint a richer, more meaningful picture of the more than one in four Massachusetts residents enrolled in the program. MassHealth serves our most vulnerable residents across their life spans from infants and children with special needs who gain access to comprehensive health care and support services required to reach their full potential, to the elderly and those living with disabilities who receive community based care that helps them remain in their homes.

Ready for Reform: Behavioral Health Care in Massachusetts

This report and companion chart pack document and describe the current behavioral health (inclusive of mental health and substance use disorder) care system for children, adolescents, and adults in Massachusetts; outline a new whole-person-oriented vision for behavioral health care in the Commonwealth; and propose a strategic approach and series of recommendations through which the state can advance this vision to achieve reform.