Health Announce: May 12, 2025

Topics for this week’s Health Announce:

1. This Wednesday! Protecting Language Access Webinar
2. Massachusetts Senate Ways and Means budget released last week reflects goal of maintaining coverage in an environment of increasing costs and needs.
3. New resources for the changes to state-funded LTSS for immigrants and CommonHealth + MSP.
4. Update on retroactive Social Security payments and asset calculations.
5. Reminder – next HGWG meeting: Wednesday, May 28, 2025.

Be well,

Health Law Unit
Massachusetts Law Reform Institute

1. This Wednesday! Protecting Language Access Webinar.

There is still time to sign up for MLRI’s webinar, Protecting Language Access, running this Wednesday, May 14, 2025, from 2pm – 3pm. Join us for a discussion about MLRI’s report, “Being Heard,” current language access laws, and how to advocate for meaningful and inclusive language access for individuals with limited English proficiency. Register here.

2. Massachusetts Senate Ways and Means budget released last week reflects goal of maintaining coverage in an environment of increasing costs and needs.

Last Tuesday, May 6, 2025, the Senate Committee on Ways and Means (SWM) released its budget proposal for fiscal year 2026 (FY 26). The budget, called S.3, includes a $2.34 billion increase over last year for MassHealth, driven by demographic pressures and increases in the cost of long-term care. MLRI’s analysis of the SWM budget and the differences between S.3, the House budget (H.4001) passed on April 30, 2025, and the Governor’s proposed budget can be found here.

Amendments to the SWM budget were due last week by 2 pm on Friday. One worth highlighting is Amendment 530, sponsored by Sen. Lovely, raising the personal needs allowance for individuals residing in nursing facilities and rest homes to $113.42 from $72.80, an amount set in 2008.

Debate in the Senate on the SWM budget and proposed amendments begins next week on May 20th. Advocates and constituents will be watching to see where the Senate moves toward agreement with the House bill and where it stays silent or moves away. For example, H.4001 included an amendment transferring $230 million from the Commonwealth Care Trust Fund (CCTF) to help the Health Safety Net (HSN). Hospitals and community health centers continue their push to increase funding for the HSN given expected shortfalls. The CCTF, which has a current balance of about $367 million with additional revenues expected this fiscal year, is the source of state funding for the subsidized health insurance program, ConnectorCare. While CCTF developed a surplus when Medicaid had the COVID pause on terminations, the surplus may be needed in FY 26 when the advanced premium tax credit enhancements expire or potentially get lowered or eliminated through the federal budget reconciliation process.

3. New resources for the changes to state-funded LTSS for immigrants and CommonHealth + MSP.

In the April 28, 2025 Health Announce, we covered MassHealth’s plans to restrict eligibility for state-funded MassHealth Standard and to provide MSP benefits to CommonHealth members with incomes of 225% FPL or less.

MassHealth has posted the Eligibility Operations Memo, EOM 25-08, titled “Pathway for Family Assistance Members to Long-Term Services and Supports at a Chronic Disease and Rehabilitation Hospital or Nursing Facility or When Residing in the Community.” As described earlier, this change affects immigrants seeking state-funded MassHealth Standard coverage for LTSS, as well as those already receiving such services. Please let us here at MLRI know if you have clients affected by this change.

There will be no EOM for the CommonHealth + MSP changes, though the regulations (130 CMR 505.000) should be updated in November of this year. Instead, MassHealth has updated its website with the necessary information, found here at Get Help Paying Medicare Costs. The website provides a link to an updated fact sheet, available in multiple languages, that describes eligibility for people on MassHealth Standard and/or CommonHealth. While MassHealth stated that the change became effective May 1, 2025, advocates have seen upgrades applied to current CommonHealth members effective April 1st. Be on the look out for MSP terminations for people with income over 225% FPL: there’s not much recourse unless the income calculation or family size was incorrect.

4. Update on retroactive Social Security payments and asset calculations.

MassHealth amended the period during which retroactive, lumpsum Social Security payments remain noncountable assets to 9 months from 6 months. The MassHealth regulation erroneously set a 6-month exclusion period, 130 CMR 520.008(H). Federal law sets the exclusion period at 9 months, Sec 431 of Pub. L. 108-203, the Social Security Protection Act of 2004; SSA changed its regulations to 9 months, 20 CFR § 416.1233. The attached updated MTF slides, p. 21-22, are the only place that acknowledges this change.

5. Reminder – next HGWG meeting: Wednesday, May 28, 2025.

‘Nuff said.