Health Care
MLRI’s Health Care Unit is committed to ensuring that all low-income and vulnerable individuals and families have access to affordable, quality health care. Our advocates work with state agencies, community-based groups and administration officials to strengthen the state’s groundbreaking health care reform law, increase access to coverage, and prepare for new opportunities which will be created with the implementation of national health reform in 2014.
Keeping Health Care Affordable:
In 2010, MLRI and its community partners successfully persuaded agency officials to maintain 2009 standards of affordability levels for the state’s Commonwealth Care program, and the corresponding affordability standards for the individual mandate. By doing so, we were able to prevent an increase in monthly premium and co-payment costs for roughly 150,000 individuals and families during these difficult economic times and, protect lower income uninsured individuals with no affordable health insurance options from tax penalties.
Removing Administrative Barriers to Health Care:
MLRI continues to advocate for new policies designed to reduce administrative complexities and promote better coordination and potential integration of numerous state-subsidized programs. By doing so, MLRI is helping to:
•Eliminate administrative barriers that discourage or erroneously deny eligible individuals from securing state subsidized health coverage;
•Address gaps in coverage individuals experience when transitioning between different state programs;
•Promote greater equality in the benefits offered by various state programs; and
•Reduce overall administrative costs.
MLRI played a lead role in pushing for legislation that required the state’s MassHealth (Medicaid) agency to allow U.S. citizens to verify their citizenship using their Social Security number rather than more onerous documentation, such as a passport or birth certificate which are often difficult for very low-income individuals to obtain. Prior to MLRI’s advocacy, MassHealth estimated that more than 20,000 citizens were unable to access coverage due to excessive verification requirements.
In January 2013, the Medical Security Program for low and moderate income individuals collecting unemployment insurance and their families will be offering benefits in its direct coverage program comparable to benefits available in the Commonwealth Care program. MLRI and its partner organizations have long advocated with state agencies for lower costs in this program for low income individuals and will be closely monitoring the changes.
Protecting Access to Health Care for Immigrants:
In 2009 the legislature, citing budget constraints, ended coverage in Commonwealth Care program for roughly 30,000 lawfully-present immigrants. Working with our community partners, MLRI successfully advocated for the establishment of a lower-cost temporary coverage program called Commonwealth Care Bridge which currently provides baseline coverage for legal immigrants. At the same time, MLRI has supported full equality for lawful immigrants and filed an amicus brief on behalf of itself, the MIRA Coalition and Health Care for All supporting an equal protection challenge to the exclusion of legal immigrants from Commonwealth Care. In a May 6, 2011 ruling, the court held that the 2009 state law will not be upheld unless it can meet the strictest judicial scrutiny. MLRI filed a second amicus brief on behalf of itself, the MIRA Coalition, Health Care for All, and the Irish International Immigrant Center in the fall of 2011 when the case returned to the Supreme Judicial Court for a determination of whether the 2009 state law was unconstitutional. The case was argued in October 2011 and is awaiting decision by the Court.
In addition, MLRI worked with state officials to exercise an option made available following the federal government’s reauthorization of the Children’s Health Insurance Program allowing lawfully present immigrant children and pregnant women to become eligible for the state’s MassHealth Program without a 5-year waiting period, benefiting approximately 7,200 children and 1200 pregnant women.
MLRI has also worked to preserve access to basic health safety net services for all state residents regardless of immigration status. MLRI was instrumental in persuading the state to amend its application form and clarify its policies on state residence in the summer and fall of 2011 to prevent eligible state residents from being erroneously denied care.
Implementation of the Affordable Care Act in Massachusetts:
In 2014, key provisions of the federal Affordable Care Act (ACA) will be implemented nationally. While the ACA will offer a number of benefits, there are several aspects of current state law that are more advantageous than what is provided under the federal law, particularly for the low-income and chronically ill.
MLRI’s health care advocates will work with policy makers, the Connector Authority, and other officials to ensure that we maintain those aspects of the state law which are more beneficial, particularly with respect to minimum standards of affordability as we work to incorporate broader aspects of the ACA which improve the state’s current health care system. By combining the best aspects of both the state and federal laws we can provide the best possible health care for Massachusetts’ residents.
In the fall of 2011, MLRI worked with national advocacy organizations and a state-wide coalition to analyze four sets of proposed federal regulations implementing various aspects of the Affordable Care Act regarding expanded Medicaid eligibility, establishing Exchanges, and determining eligibility for premium tax credits in 2014. MLRI submitted comments on each set of proposed regulations identifying policies needed to protect low income Massachusetts residents and assure them access to affordable care.
Working with People with Disabilities on the State’s Proposal for Integrating Medicaid and Medicare Services:
Massachusetts received a planning grant to develop a demonstration proposal to integrate care for adults with disabilities eligible for both Medicare and Medicaid. A newly formed coalition of individuals with disabilities and disability rights groups formed in the spring of 2011 to to advocate with the state to design a program that best meets the needs of people with disabilities and gives them optimal choice and control over their health care. MLRI is working to provide tools and information to help the coalition effectively make its case to state and federal policy makers.