Massachusetts Offices Overwhelmed By Number Of State Health Plan Applicants

August 16, 2007 – 8:53 pm | posted in Health Insurance

Thousands of Massachusetts residents are unable to enroll in state-subsidized health insurance plans because the number of applicants is overwhelming state offices, the Boston Globe reports. According to the Globe, as many as 50% of applicants for MassHealth, the state’s Medicaid program, and Commonwealth Care, a program under MassHealth that provides fully or partially subsidized insurance, are forced to submit paperwork multiple times because original documents are being lost at state offices, and many applicants are receiving contradictory information about whether they qualify for the programs.

Although the number of people affected is unclear, the delays have resulted in thousands of residents failing to obtain health insurance by the state-mandated July 1 deadline. Penalties for not obtaining coverage will not be assessed until Dec. 31.

“What we’re experiencing is the stress of success,” MassHealth Director Thomas Dehner said, adding, “We are seeing an enormous spike (in applications), and processing times are longer than they need to be.” When the law passed, officials estimated that between 140,000 and 212,000 residents would qualify for Commonwealth Care and that an additional 70,000 to 89,000 would qualify for MassHealth.

To date, nearly 105,000 people have enrolled in Commonwealth Care — 21,000 more than projected for the July 1 deadline — and 57,000 have enrolled in MassHealth. During the two weeks before and one week after the deadline, offices received more than 18,000 applications. The number of applications has declined this month, but there still is nearly double the number of applications MassHealth received last year before implementing Commonwealth Care.

Dehner said the state is reaching its goal of responding to applications within five days for those who apply electronically, but about half of the applications are on paper and are taking about 22 days to complete. According to Dehner, the state is authorizing overtime for MassHealth employees to reduce the backlog. MassHealth also is seeking to allow electronic signatures on applications to reduce the amount of paperwork, and the agency is retraining workers to ensure they are providing clear, accurate information to applicants. In addition, MassHealth is establishing an ombudsman to help with individual problems (Dembner, Boston Globe, 8/11).

“Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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