What can happen in 100 days?
Tomorrow, Tuesday, April 29, 2025, marks the end of Trump’s first 100 days in office. The destruction, disruption, and chaos he has wrought in such a short time is astonishing, from conducting illegal expulsions of our undocumented neighbors to cutting off funding for critical research into treatments for pancreatic cancer. An awful lot of awful things can happen in 100 days.
But those same 100 days have seen strong and unified resistance. Communities have rallied across the country – dozens of issues composing one movement – protesting Trump’s attacks on the Constitution, his tariff policies, his cuts to needed federal programs and funding, and more. In these first 100 days, Massachusetts Attorney General Andrea Campbell has sued the Trump Administration over a dozen times and has secured preliminary injunctions to stop the defunding of medical research and to stay the executive order purporting to end birthright citizenship. In total, over 200 lawsuits have been filed challenging Trump Administration action in his first 100 days in office.
Topics for this week’s Health Announce:
- 100 Days of Harm: rally at noon on Tuesday, April 29, 2025.
- Health Care Working Group – this Wednesday, April 30, 2025.
- Protecting Language in Massachusetts webinar now on Wednesday, May 14, 2025.
- Massachusetts House begins its deliberations on the budget this week.
- Starting May 1, 2025, MassHealth will be providing Medicare Savings Program (MSP) benefits to CommonHealth members with incomes of 225% FPL or less.
- MassHealth plans to restrict eligibility for state-funded MassHealth Standard starting May 1, 2025.
Be well,
Health Law Unit
Massachusetts Law Reform Institute
1. 100 Days of Harm: rally at noon on Tuesday, April 29, 2025.
Tomorrow at noon outside the JFK Federal Building located at 15 Sudbury Street, Boston, advocacy groups are holding an event to mark 100 days into Trump's second term. Speakers will address the changes Trump has wrought on health care, immigration, reproductive rights, access to services for older adults, and disability rights. Sponsoring groups include the Massachusetts Immigrant & Refugee Advocacy Coalition (MIRA), Disability Policy Consortium, Health Care for All (HCFA), Reproductive Equity Now, and Massachusetts Senior Action Council. You can RSVP to HCFA here.
2. Health Care Working Group – this Wednesday, April 30, 2025.
The HCWG meeting is this Wednesday, April 30, 2025, from 3:00 pm to 4:30 pm. An updated calendar invite went out two weeks ago with the zoom link for the meeting. Linda Landry from the Disability Law Center will join us to speak about federal developments and changes affecting the Social Security Administration (SSA). If you have any questions specific to SSA, or any other topics you’d like on the HCWG agenda, please send them to Kate at ksymmonds@mlri.org.
3. Protecting Language in Massachusetts webinar now on Wednesday, May 14, 2025.
On Wednesday, May 14, 2025, at 2 pm, MLRI is hosting the Protecting Language in Massachusetts webinar. Come learn about the urgency of advocating for language access in this climate, how to investigate agencies' language access performance, and ways to advocate for improvements, drawing upon lessons from MLRI's recent "Being Heard" report about language access at MassHealth. This webinar is hosted by MLRI's health and language access attorneys, with guest speakers: Leslie Diaz from Health Care for All, and Katrina Lin, a former Tufts Tisch Scholar who did the investigation for MLRI's Being Heard report.
4. Massachusetts House begins its deliberations on the budget this week.
Two weeks ago, the House Way and Means Committee released its $61.4 billion budget proposal for fiscal year 2026 (MLRI's budget analysis can be found here), and last week representatives filed 1,650 amendments. This week, the House begins deliberations. After some speeches and public debate, discussion moves behind closed doors; House leadership will meet with members about proposed amendments, and then selected amendments will be bundled into one of a few mega-amendments.
5. Starting May 1, 2025, MassHealth will be providing Medicare Savings Program (MSP) benefits to CommonHealth members with incomes of 225% FPL or less.
Background: Under the terms of the 1115 Demonstration, individuals eligible for CommonHealth were also eligible to have their Part B premium paid if their income (as determined under the CommonHealth MAGI rules) was 135% of the federal poverty level (FPL) or less. With the expansion of the Medicare Savings Program (MSP) starting in 2020, MassHealth repeatedly asked to amend the demonstration to raise the income level for coverage of Part B premiums, but could not obtain CMS approval. Finally, CMS clarified that CommonHealth members can be eligible for MSP if they qualify under the non-MAGI rules that apply to MSP. CMS also agreed MassHealth can temporarily continue to use its MAGI rules to determine CommonHealth for MSP to allow the state time to upgrade its systems to use the two different sets of income rules in making one eligibility determination.
What’s changing May 1, 2025?
- Thousands of current CommonHealth members with income of 225% FPL or less will newly qualify for MSP.
MassHealth will be automatically applying the current MSP income eligibility rules to individuals enrolled in MassHealth CommonHealth and Medicare. All will be eligible for MassHealth payment of their Part B premium (currently $184 per month for most people). People with incomes of 190% FPL or less will be enrolled as Qualified Medicare Beneficiaries (QMB) with the added benefits of QMB. People with income over 190% FPL but not over 225% FPL will be enrolled in Specified Low Income Medicare Beneficiaries (SLMB)/ Qualifying Individuals (QI) programs. This should help thousands of CommonHealth members.
- After May 1, new CommonHealth members and CommonHealth members newly eligible for Medicare with incomes of 225% or less will qualify for MSP
No change in application procedures will be needed. MassHealth will have manual systems in place to identify eligible individuals and give them the right coverage.
- 1,800 CommonHealth members with incomes over 225% FPL will no longer have their Part B premiums paid by MassHealth
Last summer MassHealth notified about 8,900 CommonHealth members who at one time had incomes under 135% FPL but now had income over 135% FPL that they were no longer eligible for MSP. This was related to the “unwinding” required after the expiration of COVID-related protections. Last fall, CMS directed the agency to reinstate these members while CMS and the state were sorting out eligibility for MSP. Now that it is sorted, those with income of 225% FPL or less will be able to retain CommonHealth and MSP, but about 1,800 with income over 225% FPL will be terminated from MSP after May 1, 2025, as over-income.
What can advocates do? We’ll be discussing this at Wednesday’s Health Care Working Group meeting.
6. MassHealth plans to restrict eligibility for state-funded MassHealth Standard starting May 1, 2025.
Background: Since November 2021, MassHealth has provided state-funded MassHealth Standard for immigrants who do not qualify for federally reimbursed Medicaid, provided the immigrants are lawfully present or PRUCOL (person residing under color of law), either meet a nursing facility (NF) level of care or need a PCA, and satisfy the other financial and nonfinancial criteria for Standard. With this expanded scope of coverage for LTSS, elderly and disabled people in hospital or NF settings could be safely discharged to a less restrictive and less costly setting. The Governor’s budget proposal for FY 2026 announced a restriction in eligibility for state-funded Standard starting this spring.
What’s changing May 1, 2025?
MassHealth has briefed stakeholders on changes starting May 1. A new eligibility operations memo (EOM) and other written materials with more details should be available by May 1. Based on what MassHealth has told us so far….
Starting May 1, 2025, the eligibility criteria for state-funded Standard will be more restrictive in two ways:
- Eligibility will require a Nursing Facility level of care. Needing a PCA will no longer be enough to establish eligibility; someone must additionally meet a NF level of care.
- Eligibility will require a hospital stay. The hospital stay requirement will be satisfied if someone was discharged to a NF and applies for state-funded Standard from the NF.
Starting May 1, 2025, people currently enrolled in state-funded Standard in the community will be reassessed for continuing eligibility:
- At least 1,500 people are currently on state-funded Standard in the community. Most are elderly and eligible for PCA services. They will be reassessed in batches of 50 per week beginning in May and continuing into November 2025.
- MassHealth has contracted with UMass (ForHealth) to do the outreach for members and to complete the clinical assessment for a NF level of care. (The hospital stay requirement will not apply retroactively.)
- In addition to the clinical reassessment, these 1,500 or more individuals will be required to return an updated SACA-2 renewal form.
- If the required forms are returned but the clinical assessment does not meet the NF level of care, the individual will be downgraded from state-funded Standard to Family Assistance.
- UMass will engage in multiple efforts to reach individuals and schedule the assessments, but if unable to do so within 30 days, the individual will receive a termination notice.
What can advocates do? We’ll be discussing this at Wednesday’s Health Care Working Group meeting.
