Officials: More time needed to assess cost of temporary Medicaid


By Andy Metzger


BOSTON — The temporary Medicaid program the state implemented to catch residents confounded by last year’s broken Health Connector website will end in February and so far about 25 percent of the transitioning population has secured coverage going forward, according to Maydad Cohen, the incoming interim director of the Connector.

Cohen, who plans to take over for Connector Executive Director Jean Yang when she steps down on Friday, said 414,000 residents were enrolled in temporary MassHealth plans or allowed to keep their subsidized Commonwealth Care coverage after technical problems last fall made it difficult to enroll in new coverage under the Affordable Care Act.

The temporary coverage pool has been cited by Gov. Charlie Baker as a “wildcard” in trying to determine the size of the state’s fiscal year budget gap because some of those enrolled in Medicaid over the past year may not have been eligible for the program. State officials have anticipated federal dollars to help cover the costs of the program.

“The wildcard piece that we’re still not entirely sure about is the MassHealth piece,” said Administration and Finance Secretary Kristen Lepore. She told reporters, “It’s part of the problem, and still there’s a lot of unknowns.”

The Massachusetts Taxpayers Foundation has estimated the budget risks for the temporary Medicaid program is between $180 million to $300 million, which Glen Shor, the Patrick administration’s secretary of administration and finance, disputed.

Cohen said it could take until April to understand the full costs of keeping 414,000 enrolled in temporary Medicaid or on Commonwealth Care plans. He said the Connector will have a better grasp of types of permanent coverage each member qualified for in early February.

“It was a hard population to estimate exactly,” Cohen told the Connector Board on Thursday. He said about 104,000 have enrolled in new coverage, and said many of those in temporary coverage may have secured employment, married or moved out of state.

Lepore said her staff has been working around the clock and the administration is “really close” to assessing the scope of the deficit, which Baker has said is more than $500 million. Baker said on the radio Thursday he would have a “hard estimate” on the size of the gap and a plan to close it next week.

The deadline for those temporary Medicaid members to select a health care plan for coverage starting Feb. 1 is next Friday, though officials could extend the deadline for making a payment, Cohen said. About two thirds of the roughly 300,000 people enrolled in temporary Medicaid will see their coverage end at the end of January, and the program will completely close Feb. 28, Cohen said.

“I think we need to send a strong message that we’re not planning to extend the deadline,” said Lepore, noting past extensions. She said, “We don’t want to create the sense that people will have more time.”

Ahead of Friday’s deadline, Cohen said he expected next week to be the busiest period of open enrollment in 2015, and said the call-centers would staff up to accommodate the anticipated crush of questions.

“This is kind of the largest wave that we’ve got,” Cohen said.

On Thursday, the Connector was 60 days into open enrollment with 30 days until the Feb. 15 end of this year’s period. The retooled website launched in November has made 353,000 program determinations, sending 175,000 applicants to MassHealth. Of the 178,000 who qualified for “Health Connector-sponsored” programs, close to 62,000 of those have paid for their plans, according to Cohen.

Cohen said more information will be needed before officials can assess the budget impact of the temporary Medicaid program and why many have not sought to re-enroll in Medicaid.

“It’s nearly impossible to be able to tell if a person got a job and is now employed. Private employers don’t have to report to us that they are now insuring Person X,” Cohen told reporters. “What we’ve done in the past is we’ve used questionnaires… to find out why people didn’t come back.”

In February and March, officials will be able to seek out answers and amass more information on the final claims associated with the program.

“Right now it’s too much guesswork, and we’re not going to participate in guesswork,” Cohen said.