\u201cIt\u2019s a little bit paradoxical, because it reflects the fact that Massachusetts has a pretty generous safety net already,\u201d Hempstead said.<\/p>\n
It\u2019s already easier for parents in Massachusetts to be eligible for MassHealth than in other states, Hempstead said. The population in Massachusetts that is able to get Medicaid through an expansion of the insurance program, aimed at opening the insurance to more low-income adults, includes more non-parents who are less likely to qualify for an exemption.<\/p>\n
Additionally, Massachusetts has a higher minimum wage than other states, meaning that many workers already earn more than is allowed to qualify for MassHealth. <\/p>\n
\u201cThe Medicaid expansion population then has fewer employed people,\u201c so they\u2019re less likely to be able to stay on Medicaid under the new requirements, Hempstead said.<\/p>\n
Beginning Jan. 1, 2027, MassHealth members ages 19 to 64 who qualify for the insurance through the Affordable Care Act, or Obamacare, expansion will have to prove that they work or volunteer for at least 80 hours per month, unless they meet certain exemptions, such as caregiving for children under 13, being pregnant, or being medically frail. MassHealth members will also have to have their eligibility rechecked every six months. <\/p>\n
The changes could prove financially disastrous for Massachusetts hospitals who rely on Medicaid<\/a>, especially those that care for a high proportion of low-income patients. If patients are kicked off of the insurance and unable to find other coverage, hospitals foot the bill for emergency care. Already, UMass Memorial Health has slashed<\/a> some services.<\/p>\n MassHealth\u2019s estimate<\/a> for people who will ultimately lose coverage because of these requirements \u2014 about 175,000 Massachusetts residents \u2014 falls toward the higher range projected by the report. <\/p>\n \u201cWe are really committed to implementing these changes in the most thoughtful way that minimizes impact to the members and coverage, while, of course, maintaining that federal compliance,\u201d said Elizabeth LaMontagne, MassHealth chief operating officer.<\/p>\n In their projections, report authors considered each state\u2019s population who currently qualify for Medicaid under the Obamacare expansion and estimated how many could prove they are working and how many meet the standards for an exemption. The Robert Wood Johnson Foundation is a New Jersey health equity philanthropy and the Urban Institute is a nonprofit research organization focused on social and economic policy in Washington.<\/p>\n Massachusetts residents between the ages of 50 and 64 are particularly vulnerable, Hempstead said, because they may have health problems that don\u2019t qualify as a disability but that limit their ability to work. Medicare, the federal health insurance program for older adults, doesn\u2019t kick in until age 65. <\/p>\n The work requirement exemptions include medical frailty, but the federal government hasn\u2019t defined what specific conditions will be considered exempt. The Centers for Medicare & Medicaid Services are supposed to give written guidance on the rollout of the work requirements in June, LaMontagne said.<\/p>\n