As part of $11 million effort to help Massachusetts residents maintain health coverage

At the community health center in downtown Lowell, patient navigator Abbas Tanner made one phone call among the dozens he and his colleagues reportedly made that day.

On the line was a 29-year-old woman from Leominster who needed help renewing her insurance from MassHealth, the state’s Medicaid program. Tanner asked a series of questions about his family, income and immigration status, typing her answers into her laptop.

Enlaces Patrocinados:

«Has any information changed regarding your tax return status?» Tanner asked the woman. An interpreter, Maria Cruz, translated into Portuguese. After about 15 minutes, they renewed the patient’s insurance under MassHealth.

Outreach worker Carrie Perez leaves information about MassHealth at the door of a home in Revere.  (Jesse Costa/WBUR)
Outreach worker Carrie Perez drops information about MassHealth’s renovation at a home in Revere. (Jesse Costa/WBUR)

This job of guiding people through the sometimes tedious task of getting health coverage is critical right now. It is part of a sweeping effort across Massachusetts to help low-income families and individuals maintain access to health care during a turbulent time for MassHealth.

During the COVID health emergency, federal rules allowed Medicaid beneficiaries in Massachusetts and other states to keep their benefits indefinitely, even as their income increased. But the grace period is over. Now, people have to prove they are qualified.

If for some reason they don’t get the renewal notice or don’t respond fast enough, they could lose health coverage altogether.

The burden is especially high for immigrants and communities of color who don’t speak English or don’t have easy access to technology.

«Patients and community members who tend to fall through the cracks are the ones who are most vulnerable,» said Brenda Rodriguez, head of strategy and chief financial officer at Lowell Community Health Center. «They may not have a working computer or cellphone to track and fill out an online form, or they may have other barriers.»

State officials are spending at least $11 million on a campaign to reach 1 in 3 state residents who rely on MassHealth.

The stakes are high. People who lose their insurance may be less likely to seek health care when they need it, or they may face large costs for treatment.

And there are wider implications. The landmark Massachusetts Health Care Act of 2006 was a blueprint for the Affordable Care Act, and over 97 percent of Massachusetts residents are insured. A decline in this number would be an embarrassment to a state that has developed a reputation for protecting access to health care.

«Universal coverage is our lodestar,» said Mike Levine, assistant secretary of MassHealth.

MassHealth covers 2.4 million people. Levine said state officials hope to automatically renew up to half of them, using income data from public programs. They’re following that goal but working towards it, Levine said.

An outreach worker in Revere shares information about MassHealth.  (Jesse Costa/WBUR)
An outreach worker in Revere shares information about MassHealth. (Jesse Costa/WBUR)

The process to determine who is eligible for MassHealth began in April and is expected to take a year. State officials mail out tens of thousands of renewal notices in blue envelopes each month. Members have at least 45 days to respond.

But there are fears that people may not get this important mail from MassHealth because they’ve changed addresses. Or they may receive the letter and not understand that they have to respond.

Health policy nonprofit KFF estimates that between 8 million and 24 million people nationwide will lose Medicaid coverage during this vetting process, many of whom are eligible for benefits but are kicked out of coverage because they don’t meet the criteria. renewal notices.

Already, data from states that have moved fastest to reduce their Medicaid enrollments show more than 70 percent are losing coverage for procedural reasons, such as not returning forms, according to KFF.

Levine said this early data from other states underscores the need for awareness and education so people don’t inadvertently lose coverage.

«We’re not going to stop trying to get that number as low as possible,» he said.

The state’s campaign to reach MassHealth members ranges from community events and television ads to calls and text messages.

The information is available in nine languages: English, Spanish, Portuguese, Arabic, Haitian Creole, Cape Verdean Creole, Khmer, Chinese and Vietnamese.

Danielle O'Brien, Carrie Perez, and Darius Barnett go door-to-door in Revere distributing information about MassHealth renewals.  (Jesse Costa/WBUR)
Danielle O’Brien, Carrie Perez, and Darius Barnett go door-to-door in Revere distributing information about MassHealth renewals. (Jesse Costa/WBUR)

Outreach workers are going door-to-door in Chelsea, Brockton, Framingham and a dozen other high-density communities on MassHealth. They knocked on more than 260,000 doors and spoke to 55,000 people in just two months.

«This is a huge undertaking,» said Maria Gonzalez, who helped launch the awareness campaign at Health Care For All, a consumer advocacy group hired to work with the state.

If MassHealth members don’t take steps to renew, «there’s a chance they could lose coverage and that’s what nobody wants,» Gonzalez said.

A MassHealth poster in Haitian Creole.
A MassHealth poster in Haitian Creole.

Enrollment specialists, including those at Lowell Community Health Center, are working across the state to help people renew their MassHealth insurance or switch to other plans.

People who become ineligible for MassHealth are eligible for subsidized plans on the state’s insurance exchange, called the Health Connector, and about 16,000 have already done so. (Some Connector plans have premiums of a few dollars a month.) Other people who leave MassHealth may be able to get health coverage through their employers.

Massachusetts is doing more than other states to help people stay covered. But advocates still fear it may not be enough.

«It looks like a mess to me,» said Heloisa Galvo, executive director of the Brighton-based Brazilian Womens Group, which works with Brazilian immigrants.

He said it’s complicated for people who don’t speak English to get information when they call MassHealth.

«It has to be done in a humane way,» Galvo said. «If you’re new here, and if you don’t know how it works, and if you don’t speak the language, it’s scary, scary, scary.»

State officials have set up a dashboard to track changes in MassHealth enrollment, though it’s too early to know how many people are losing coverage for not returning forms or other procedural reasons. At a recent public meeting, State Health Secretary Kate Walsh was bracing herself for a tough summer.

«People are going to show up for their kids’ school physicals and hear they’re not enrolled,» Walsh said. «That’s what we were trying to avoid, but it will definitely be hand-to-hand combat.»

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