Apr 10, 2024 - News

Feds could help fund health care pilot for middle-income earners

Illustration of a stethoscope made from a coin.

Illustration: Shoshana Gordon/Axios

Massachusetts' request for some $2 billion in federal Medicaid funding could help sustain the state's new health care subsidies for middle-income earners.

The big picture: Declining revenues, increased migrant shelter costs and rate hikes are straining state budgets.

  • The current fiscal picture could prompt lawmakers to rethink progressive subsidy programs like the ConnectorCare pilot.

Catch up fast: Massachusetts' two-year pilot, which took effect Jan. 1, expands subsidized health care to residents who earn up to 500% of the federal poverty line, up from 300%.

  • ConnectorCare helps locals who make too much or otherwise don't qualify for Medicare and Medicaid and can't get employer-based insurance.
  • Lawmakers expected about 50,000 to enroll under the pilot.

Massachusetts asked the feds in its request amending its current Medicaid waiver to expand its ConnectorCare coverage to include those middle-income earners.

  • The additional funding would "further mitigate cost 'cliffs' among the commonwealth's different insurance programs."
  • Massachusetts' request also proposes using Medicaid funding to cover housing for homeless populations, including migrant families in the emergency shelter system.

State of play: The state had 46,000 people in the ConnectorCare pilot as of February, the latest month of data available.

  • The pilot program is mainly funded through tax credits and a state trust fund, but Massachusetts could get more funding from the feds in under a month if its request is approved.

Zoom out: Massachusetts' health marketplace is seeing an increase in enrollment as the state redetermines' MassHealth members' eligibility for coverage.

  • The marketplace grew to 287,000 individual members in February, with 94,000 people joining after losing MassHealth coverage in January, per a recent report by the Massachusetts Taxpayers Foundation.

Reality check: It's still too early to tell the pilot's long-term impact on the state's insured population, MassHealth enrollment and overall health insurance system, MTF's report notes.


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