This UPDATED (October 2023) edition of the MassHealth: The Basics chart pack provides new data on MassHealth enrollment and spending from the most recent state fiscal years available. The chart pack features a high-level overview of the delivery systems that serve MassHealth members. It also highlights MassHealth’s latest reform efforts, which include initiatives to advance health equity and to improve timely access to behavioral health care.
Health Care Financing
Massachusetts administers much of MassHealth through an 1115 Demonstration waiver, approved by the Centers for Medicare and Medicaid Services (CMS), which it has extended several times since it was originally approved in 1995. In December 2021, Massachusetts submitted a request to CMS to extend its Demonstration for another five years.
In December 2021, Governor Baker signed Chapter 102 of the Acts of 2021 into law. This legislation, often referred to as the “ARPA bill,” appropriates close to $4 billion, including $2.55 billion in funding directly from the federal American Rescue Plan Act (ARPA). ARPA was passed in March 2021 to provide money to states to start recovering from the effects of the COVID-19 pandemic. Chapter 102 invests money from ARPA in many areas, including housing, infrastructure, education, and economic development.
Expanded Coverage and Savings: Effects in Massachusetts of Extending the American Rescue Plan Act's Enhanced Marketplace Subsidies
This report provides an analysis of the impacts of the enhanced premium subsidies for purchasing health insurance through the Marketplace, or Health Connector in Massachusetts, that the American Rescue Plan Act (ARPA) temporarily authorized through 2022.
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.
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.
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.
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.
Federal authorization for the Children’s Health Insurance Program (CHIP) expired on September 30, 2017. Senators Orrin Hatch (R-UT) and Ron Wyden (D-OR) have filed a bill to extend CHIP for five years, but Congress did not act quickly enough to prevent the current authorization from expiring. Unspent federal CHIP funds may be carried over into the next fiscal year and Massachusetts’s current allotment of federal CHIP funds should allow the state to continue to use CHIP funds for benefits until early 2018.
UPDATED (September 2017) chart pack produced by the Massachusetts Medicaid Policy Institute (MMPI), a program of the Blue Cross Blue Shield of Massachusetts Foundation, in partnership with the Center for Health Law and Economics at the University of Massachusetts Medical School. This updated edition includes MassHealth enrollment as of May 2017 and spending from state fiscal year 2016. It is made available in PDF and PowerPoint formats to facilitate its use in presentations.
This chart pack provides an overview of the Senate-proposed Better Care Reconciliation Act of 2017, highlighting some of its key provisions, particularly as they relate to Medicaid. Developed by Manatt Health, this chart pack was commissioned by the Blue Cross Blue Shield of Massachusetts Foundation for the Massachusetts Coalition for Coverage and Care.
This report describes the Children’s Health Insurance Program (CHIP) in Massachusetts and its role as part of MassHealth. Though there is no expiration date for CHIP in federal law, Congress has authorized funding of the program through September 30, 2017. Without Congressional action, a majority of states, including Massachusetts, will exhaust their current federal CHIP allocation by March 2018. This report discusses the importance of CHIP and the broader health policy debate, including reauthorization, now taking place in Washington.
This issue brief describes the key elements of the most recent MassHealth 1115 waiver extension, including the shift to a delivery system centered on Accountable Care Organizations and Community Partners, a Delivery System Reform Incentive Program, the redesigned Safety Net Care Pool, and the expansion of services for treatment of substance use disorders. It concludes with a discussion of implications of the new system for major stakeholder groups.
This budget brief highlights the fiscal year (FY) 2017 budget for MassHealth (Medicaid) and other subsidized health coverage programs. It is the last in a series of FY2017 budget briefs produced by the Massachusetts Medicaid Policy Institute (MMPI) in partnership with Health Management Associates.
UPDATED (June 2016) chart pack produced by the Massachusetts Medicaid Policy Institute (MMPI), a program of the Blue Cross Blue Shield of Massachusetts Foundation, in partnership with the Center for Health Law and Economics at the University of Massachusetts Medical School. This updated edition includes MassHealth enrollment as of January 2016 and spending from state fiscal year 2015 and is made available in PDF and Power Point formats to facilitate its use in presentations.
Comparison of the FY2017 House and Senate Budget Proposals for MassHealth (Medicaid) and Health Reform Programs
This brief describes the Massachusetts Senate fiscal year (FY) 2017 budget proposal for MassHealth (Medicaid) and other subsidized health coverage programs and compares it to the proposal put forth by the House. It is the third in a series of FY2017 budget briefs produced by the Massachusetts Medicaid Policy Institute (MMPI) in partnership with Health Management Associates. MMPI will be publishing budget briefs at several stages in the FY2017 budget process as proposals move through the state legislature.
Health Care and Social Service Spending and Outcomes: How Does Massachusetts Compare with Other States?
International comparisons of industrialized countries show that those with a higher ratio of social service spending relative to health care spending have better health outcomes. This finding is consistent with decades of research underscoring the importance of social, behavioral, and environmental factors on health outcomes.
This report, prepared by Manatt Health, lays out a vision for MassHealth long-term services and supports (LTSS) that is person-centered, integrated, sustainable, accountable, and actionable, providing Massachusetts policymakers with a set of options to consider when tackling some of the most intractable challenges facing the Commonwealth’s LTSS system.