Policy Issue

Policy Watch: COVID-19 & MassHealth

October 14, 2021

COVID-19 has brought an ever-changing landscape of federal rules and legal protections, in addition to protections enacted at the state level. One example of this is MassHealth protections during the public health emergency.

The Families First Act of 2020 provided financial incentive to states to protect individuals enrolled in Medicaid programs during the public health state of emergency as declared by the U.S. Department of Health and Human Services (HHS). Massachusetts accepted the financial incentive, and therefore MassHealth members are protected from losing coverage or paying increased premiums during the emergency. State governors were assured by the Biden administration in January 2021 that the HHS state of emergency will remain through at least the end of 2021.

Federal rules took effect in November 2020 that allowed state Medicaid programs to make changes to an individual's coverage so long as they retained benefits comparable to their current plan. Certain MassHealth members, particularly those with disabilities, may have been "downgraded" to a plan that does not carry the same long-term services and supports that they had previously. These situations are complicated, and it is difficult to estimate the number of people affected in the region. This summary published in June by Massachusetts Law Reform Institute provides more details on specific cases that require advocacy on the part of medical-legal professionals.

While some members may experience a downgrade, most members are protected from losing coverage entirely during the HHS-declared public health emergency. But, public health professionals should be prepared for when the federal public health emergency ends, as many MassHealth recipients may require assistance with submitting information or renewal forms or understanding other changes to their plans. For an overview of frequently asked questions about MassHealth and COVID-19, please visit the state's website.

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