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March 23, 2021 Update


It was 11 years ago in March that the ACA was enacted, and one year ago that the Governor declared a state public health emergency, so it feels particularly appropriate to be relaying today's update with good news about reducing barriers to enrollment for immigrants, plans to expand MassHealth eligibility and services to address health disparities, and the sweeping expansion of affordable coverage available through the Health Connector under the American Rescue Plan Act.

Updated EOHHS information on public charge On March 9, 2021 the federal government announced that it was returning to its 1999 guidance on public charge. Under the 1999 guidance federal Medicaid, SNAP, federal public and subsidized housing and vouchers are not considered evidence of public charge. The only public benefits that are still relevant to public charge are cash welfare assistance for income maintenance like SSI, TAFDC and EAEDC and government payment for long term care in a nursing home or other medical institution. EOHHS has provided clear and helpful information on including links to the March 9 announcement, the 1999 Guidance and other resources. 

MassHealth announces plans to request amendments to the 1115 Demonstration to expand eligibility and enhance services. MassHealth has posted its proposed amendments and  scheduled a listening session  on March 31 from 2-3 pm and will be accepting written comments until April 25, 2021. The amendments include:   

·         Increasing the income limit for Medicare Savings Program benefits without an asset test from 135% to 165%, and allowing MassHealth Standard members eligible through the State Plan to also be eligible for payment of Medicare Part B premium at this income level. 

·         Extending eligibility for postpartum coverage from the current 60 days to 12 months including for pregnant member not otherwise eligible for postpartum coverage due to immigration status.

·         Providing community support program benefits for justice-involved individuals 

·         Making permanent certain COVID 19 flexibilities regarding the place of service 

MLRI paper on what we know so far about how the American Rescue Plan Act will expand access to affordable coverage in Massachusetts. At the Health Connector's Mar 11 board meeting, its ED called the ARPA the biggest expansion of affordable coverage since the ACA:  It redefines affordable Health Connector coverage for 2021 and 2022 and extends premium tax credits for the first time to people with income over 400 percent of the poverty level, and much more. The Health Connector is planning to automatically adjust premium contributions for its members in April and May, however others enrolled through the Health Connector at full cost as well as  the uninsured will have to submit an application and, if eligible, enroll in order to take advantage of new opportunities for affordable coverage. Some of the key implementation details have yet to be determined, but here’s our first pass on what the ARPA will mean for health coverage in Massachusetts.