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MassHealth seen as critical to children’s coverage rate

About 12,000 children in Massachusetts lack health insurance, giving the state a 99 percent coverage rate among its 1.39 million children.

That’s according to data presented recently by the Massachusetts Budget and Policy Center, one of several organizations that took part in a “checkup” gauging the status of programs and policies related to children’s health.

“Almost every single kid has health insurance,” Nancy Wagman, MassBudget’s Kids Count program director, said at the briefing, hosted by the Children’s Health Access Coalition.

Wagman said some of the 12,000 children without insurance can be explained by “natural churn,” but efforts should be made to get those kids enrolled in plans.


“There is no child in Massachusetts who should be without health insurance,” she said. “Let’s get that circle around every single one of those kids.”

About 640,000 children are “touched by” MassHealth, with the state Medicaid program serving as either their primary or secondary form of insurance, Wagman said. It’s a statistic she said is “not an accident” but the result of decisions made on Beacon Hill to extend coverage.

MassHealth is the largest spending area in the state budget. In hopes of controlling MassHealth costs, Governor Charlie Baker in his fiscal 2019 budget proposal included new tools to manage growth in the program’s pharmacy spending and a transition of 140,000 non-disabled adults with incomes between 100 percent and 138 percent of the federal poverty line off of MassHealth and onto comparable plans at the Massachusetts Health Connector.

Josh Greenberg, vice president of government relations at Boston Children’s Hospital, said the population of kids covered by MassHealth in Massachusetts includes both those on Medicaid and those insured through the Children’s Health Insurance Program.

“It covers over 40 percent of the kids in the state, so if you want to think about where health policy for children in the state of Massachusetts is set, the Medicaid program and MassHealth is a really good place to start in terms of who’s covered, what the benefits are,” Greenberg said.


A series of measures recently taken by Congress funds the Children’s Health Insurance Program, or CHIP, through Sept. 20, 2027, Greenberg said. Last year, Congress missed a September funding deadline for the program, sparking uncertainty about its future and how families with CHIP coverage would pay for care if the authorization dried up.

“It’s a little nicer for us to be in the room today without worrying about certain programs not being available from the federal government,” said state Senator James Welch, who co-chairs the Public Health Committee. “I know that that’s one cloud I think that we’ve at least diverted for the time being, and I think that’s an important one.”

Wagman, of MassBudget, said the state receives 88 cents on the dollar in federal matching funds for CHIP, but she cautioned the reimbursement amount is slated to decrease beginning in fiscal 2020.

Massachusetts stands to lose $73 million in revenue in fiscal 2020, $175 million in 2021, and $207 million in 2022, she said.

“This is going to be something we need to think about,” Wagman said.