Massachusetts Might Face $147M Funding Shortfall In Health Reform Plan

Armen Hareyan's picture

Massachusetts could face a $147 million funding shortfall by the end of this fiscal year if enrollment in Commonwealth Care continues at a higher-than-expected rate, the Boston Globereports. Commonwealth Care provides comprehensive health coverage topeople who do not have access to insurance through their employers andwho have incomes less than 300% of the federal poverty level. The statefully or partially subsidizes premiums for Commonwealth Carebeneficiaries based on income, and beneficiaries are required tocontribute copayments for services.


The state had set a goalof enrolling 136,000 people in the program by June 30, 2008, but sinceOctober 2006, 133,000 people have enrolled in Commonwealth Care. If thecurrent pace continues, enrollment could reach 178,280 by June 30,2008, and cost the state $619 million. The state budgeted $472 millionfor the subsidized program this fiscal year based on previousenrollment estimates.

If the state faces a budget shortfall, then Leslie Kirwan, secretary of administration and finance and chair of the Commonwealth Health Insurance Connector Authority,could shift funds from the $448 million Health Care Safety Net TrustFund to close the gap. However, some health care providers questionwhether the safety net has been adequately funded. Kirwan indicatedthat the state would not seek enrollment caps. "It's too early to makeany departure from the health reform plans," Kirwan said, adding, "Wewill follow the trends and adjust, if needed."

Connector CFOPatrick Holland, who compiled the new data and estimates, said thataverage monthly medical costs incurred by Commonwealth Carebeneficiaries were lower than expected (Dembner, Boston Globe, 11/18).

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