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April 28, 2022

Report: Significant portion of MassHealth members could lose coverage in July

Photo | Courtesy | Blue Cross Blue Shield The Boston offices of Blue Cross Blue Shield of Massachusetts

Up to 200,000 people could be at risk for losing eligible MassHealth coverage this summer, a new report by Blue Cross Blue Shield of Massachusetts Foundation warns.

In the initial phases of the COVID-19 pandemic, MassHealth received enhanced federal funding on the condition its members receive continuous coverage and remain enrolled despite any changes that would otherwise affect their availability. That condition is set to expire on July 14, meaning a portion of MassHealth’s 2 million members may be at risk of losing coverage.  

The report highlights some of the risks that the resuming of re-enrollment processes for MassHealth may entail. According to the report, vulnerable members of the population, even if they remain eligible for coverage, may still not be renewed for coverage if they fail to respond to all documentation requests in time, a process known as administrative or procedural termination.

“The risk of coverage loss at redetermination is especially acute for people of color and individuals who are homeless or who experience unstable housing,” the report notes. “Changes in circumstances related  to employment, income, and housing during the pandemic – social factors experienced disproportionately by people of  color – heighten the risk of individuals losing coverage as a  result of procedural terminations during redetermination.”

Though the report did not specifically say how many people could stand to lose coverage, it noted that prior to the pandemic, it was estimated around 10% of eligible Medicaid members nationwide experienced loss of coverage due to procedural termination. Applying that percentage to current MassHealth members means that more than 200,000 people could be at risk of experiencing procedural termination.  

In a press release statement about the study, BCBSMA CEO Audrey Shelto highlighted the need for a plan to prevent a massive loss of coverage.

“The federal enhanced funding resulted in significant coverage gains and much-needed health care stability not only in Massachusetts but in Medicaid programs nationally during the pandemic,” Shelto said.  “It is critical to protect those coverage gains as we transition to a new phase after the public health emergency is technically over.”

To plan for the loss of continuous coverage in July, the report recommends implementing several strategies, including processing pending redeterminations of eligibility over a one-year period and implementing a text messaging strategy to send reminders to members. 

“Given the potential for significant coverage loss and widened inequities as the Medicaid continuous coverage requirement ends, it is critical for states to use all the tools at their disposal to ensure that people who remain eligible stay covered," the report said.

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