Hundreds of thousands expected to go through MassHealth redetermination process

MassHealth, the state’s health insurance program, is slated to begin its process of eligibility redetermination starting April 1, effectively ending a federal pandemic-era policy that suspended the annual review of whether people qualified for public health coverage.

The Healey administration estimates MassHealth enrollment will fall from 2.3 million people to around 1.9 million people over the course of the year-long process, freeing up $1.9 billion for the state budget for fiscal 2024.

While nearly 400,000 people currently enrolled in MassHealth are expected to lose their coverage, according to the Healey administration’s estimates, public health officials and legislators say the state is prepared.

At a Joint Ways and Means Committee hearing on health care investments in Gov. Maura Healey's fiscal 2024 budget proposal, Assistant Secretary for MassHealth Michael Levine said that the public insurance program is preparing for the onslaught of work checking the eligibility of those 2.3 million enrollees, and helping those who no longer qualify transition to other coverage.

As the state struggles with a labor crunch, MassHealth hopes to double its call center workforce capacity in the next two months to deal with determining eligibility.

MassHealth is boosting its workforce to help deal with redetermination of eligibility

The agency is ramping up its workforce across the board, Levine said, including doubling the amount of customer service representatives in call centers to 320, hiring an additional 100 workers to determine eligibility, 80 to 100 temporary employees to process applications, and using grants to scale up the certified application counselor workforce.

Levine said MassHealth is looking to make the application process easier and remain transparent throughout the redetermination process.

The agency cut the long MassHealth application by about 75 percent for applicants over 65 years old, Levine said, and next month they will begin allowing seniors to do their applications over the phone. These calls will take 90 to 120 minutes, "but it's a start" at making the process more accessible, he said.

Beginning in May, MassHealth officials will begin publishing a public dashboard that will show where the people who are losing MassHealth coverage live, their demographics, and the reasons behind lost coverage.

Sen. Julian Cyr, D-Truro, said about half of MassHealth members are expected to be automatically renewed.

“There is no need to panic, there are windows built into the redetermination process so that people don't lose coverage immediately,” Cyr said.

Maria Gonzalez, the MassHealth Redetermination Campaign Director at Health Care For All, a nonprofit advocacy group focused on promoting health equity and fair access to medical coverage, said the goal is not to kick anyone off insurance.

“The message really is that even though the health insurance landscape is extremely complicated to navigate, Massachusetts has a lot of programs and has a lot of opportunities for people to have access to health insurance,” Gonzalez said. “Until they are up for renewal, until they complete the redetermination process, they are going to be covered by MassHealth.”

For those who do not qualify for auto-renewal, Gonzalez said they should update their contact information through MassHealth and be on the lookout for blue envelopes arriving in the mail which contain instructions for redetermination.

“After they receive the blue envelope they will have 45 days to respond, and that's when they really need to take action,” she said. “But I don't want people to worry right now until they receive that letter, right now what people need to do is to really update the information so that they can receive the letter, and they can take action once they receive the letter.”

There are skeptics about MassHealth's call center hiring.

After personal and professional challenges navigating the MassHealth system, state Rep. Ann-Margaret Ferrante of Gloucester said she is worried that elderly and disabled people are going to have trouble navigating the redetermination process, regardless of the new hires.

"I don't buy for a second that 150 people are going to help the situation," Ferrante said at the hearing. "As someone who has a family member who's blind, happens to be my mother ... Please call her when she needs to fill out her redetermination paperwork. Mail is difficult because she's blind. And unless somebody accesses the mailbox for her and knows that something's coming, she may not get that piece of paperwork."

On the Cape, Ami Bowen, vice president of Marketing and Community Engagement at Harbor Health Services, said community health centers like the Hyannis facility the company operates are going to play a key role in redetermination.

“Health insurance, in general, is a really intimidating and difficult topic for everyone,” she said. “So I think one thing that all community health centers are working on right now is just making sure that our patients and members of the community know that there are resources available.”

Community health centers, Bowen said, primarily work with patients of low- to moderate-income levels, many of whom are currently covered by public health plans. And while the prospect of losing coverage poses a good deal of concern for patients, she said the options in the event they are determined to be ineligible for MassHealth are robust.

“We understand that the thought of losing access to health care is extremely frightening to folks,” Bowen said. “If it’s determined that they are no longer income-eligible, there are options for health insurance and there is support for identifying what those options are.”

Sen. Cyr: Use the Massachusetts Health Connector to seek out coverage

One of those tools is the Massachusetts Health Connector, Cyr said.

“Many people who will be deemed ineligible for MassHealth will likely be eligible for subsidized health insurance coverage through the Health Connector,” Cyr said. “And to that end, the Health Connector is holding a special enrollment period from April to November, and they're going to increase the public information campaign.”

Mass.gov offers important steps for current MassHealth members

• Update your contact information. Make sure MassHealth has your most up to date address, phone number and email so you do not miss important information and notices from MassHealth.

• Report any household changes. These include a new job, address, changes to your income, disability status, or pregnancy.

• Create an MA Login Account. An MA Login Account is the fastest way to renew your MassHealth and Health Connector coverage, update your information, and report changes to your household. Current members under the age of 65 can create an account by following the link provided on the back of your MassHealth notices or by visiting mass.gov/masshealthlogin.

• Read all mail from MassHealth. MassHealth will mail you information about your health benefit that may require you to take action to keep your current coverage. Look out for a blue envelope in the mail and make note of the important deadlines.

Additional guidance:

If you think you may no longer be eligible for MassHealth, other health coverage options are available, such as an affordable plan through the MA Health Connector.

Members can visit https://www.mahealthconnector.org/ or call customer service at 1-877- MA ENROLL (1-877-623-7773) to learn more or enroll in a plan.

Losing MassHealth coverage is a Qualifying Life Event (QLE), which allows members to enroll in a plan through the Health Connector outside of the regular Open Enrollment Period.

Material from the State House News Service was used in this report

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This article originally appeared on Cape Cod Times: MassHealth insurance program to begin eligibilty redetermination