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CQC Urges Massachusetts Health Care Consumers to Weigh in on Baker Proposal to Change Medicaid

WASHINGTON – Consumers for Quality Care (CQC) is urging Gov. Charlie Baker to reconsider aspects of his plan to radically reshape MassHealth, and to steer clear of adopting new harmful insurance practices into the program.

Just last month, Gov. Baker released a new Medicaid proposal for comments from the public. The proposal comes in the form of a waiver request from the federal government to consolidate and restructure coverage for non-disabled adults in Massachusetts, moving approximately 140,000 low-income enrollees to subsidized commercial plans.

“By placing these individuals into the Health Connector, out-of-pocket costs will increase and Massachusetts will effectively be rationing people’s health care by providing it to only those who can afford it,” CQC board members said. “Today, Medicaid out-of-pocket costs, including premiums, are limited to five percent of total income. When beneficiaries are moved off of MassHealth, they will be subject to out-of-pocket costs up to $1,250 annually for an individual and $2,500 for a family -- more than twice what recipients currently pay.”

In March, U.S. Department of Health and Human Services Secretary Tom Price and Centers for Medicare and Medicaid Services Administrator Seema Verma encouraged the governors to seek to “align Medicaid and Private Insurance Policies for Non-Disabled Adults.”

Under Baker’s proposal to change MassHealth:

  • Beneficiaries could be required to pay for dental care, a benefit that is currently accessible to enrollees;
  • 230,000 poor non-disabled adults would be moved into a common Alternative Benefit Plan that reduces access to long-term care services and coverage for non-emergency medical transportation; and
  • Access to life-saving and medically necessary medicines would be reduced for the entire MassHealth program, restricting available medications and denying patients access to the latest drugs approved to treat cancer and HIV.

“Medicaid may have things it can learn and adopt from the insurance industry, but practices like these aren’t among them,” the board said. “Before Gov. Baker takes the Trump Administration up on its offer to change the commonwealth’s Medicaid program, we urge the people of Massachusetts to make their voices heard.

These changes demand careful consideration because no one should lose their care.”

CQC is also imploring Gov. Baker to keep Medicaid beneficiaries top of mind as he finalizes waivers requests from federal Medicaid standards adopting the following principles for assessing the scope and breadth of his waiver request:

  • High-quality, comprehensive health care should be available and affordable to all Americans;
  • Insurance design should be improved to better meet the needs of consumers; and
  • The health care delivery system should be modernized to put the patient at the center.

CQC is led by a board of directors that includes Jim Manley, former senior advisor to Senators Edward Kennedy and Harry Reid; the Honorable Donna Christensen, physician and former Member of Congress; Scott Mulhauser, visiting fellow at The University of Pennsylvania and former senior advisor to the Senate Finance Committee and Vice President Joe Biden; and Jason Resendez, Executive Director of the LatinosAgainstAlzheimer's Network and Coalition.

To view the proposed Medicaid waiver visit: www.mass.gov/hhs/masshealth-innovations/1115waiver.

To learn more about Consumers for Quality Care and the issues consumers are experiencing, visit www.consumers4qualitycare.org.


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