Guidelines for Mass Health

MassHealth is a government-assisted health insurance program offered to residents of the state of Massachusetts. The program was instituted as a part of the Massachusetts Health Care Reform Law of 2006. Under the law, every Massachusetts resident must have health insurance, and no one can be denied coverage due to job status, income, health, age or any other factor.

• Boston, Massachusetts. State law stipulates that every Massachusetts resident must have health insurance.

Purpose

• MassHealth aims to provide quality, affordable healthcare to low- and medium-income citizens of Massachusetts. Under MassHealth, the national health insurance program Medicaid and the national Children's Health Insurance Program (CHIP) are combined.

Eligibility

• Eligibility for MassHealth is determined using state and federal poverty guidelines. Only Massachusetts residents are eligible. The MassHealth program was specifically designed with children, parents, employees of small companies, the unemployed, pregnant women, the disabled and the elderly in mind. The program also supports the mentally ill, people who have been diagnosed as HIV-positive, cancer patients and others in need of long-term care.

Funding and Oversight

• MassHealth is a state agency that is overseen by the Massachusetts Executive Office of Health and Human Services. Half of the program's costs are provided by the federal government, while the other half are covered by the Massachusetts state government. Annual costs average around $9 billion.

Statistics

• According to an October, 2009, report by the Boston Herald there were 1.174 million MassHealth members in May 2008, and by August 2009, enrollment had grown to 1,251,900. The program's popularity has made it a testing ground for other states exploring public healthcare options and interest groups who seek to establish a similar program at the federal level.

Criticism

• Critics of MassHealth claim the program does not have enough funding to cater to the ever-growing number of participants and will eventually suffer drastic economic shortfalls without reorganization. They believe program members should be placed in managed care plans as opposed to "fee for service" programs, which are more costly to provide.