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Massachusetts Health Insurance
Still Struggling with Universal Mandate
March 2008
Since Massachusetts health insurance became mandated by law, the state has been struggling to work serious kinks out of the system. Whether it's costs, coverage, or enrollment, there seems to be a new hurdle at every turn. Now, as hospitals struggle with patients who don't have medical insurance, and no funding to treat them, the state will have to step in to prevent the growing threat of medical debt.
The concern is that many Massachusetts safety net hospitals in urban areas say they are facing budget shortfalls because payments for charity care are being phased out under the state health insurance law. Too many patients seeking care in such hospitals still don't have medical insurance, and hospitals still must treat such patients, although they no longer receive funds to provide the care.
This snag is the latest in a procession of concerns that appeared when Massachusetts health insurance went universal, and the law mandated coverage for everyone. First too many people signed up, and there were concerns about the state going bankrupt. Then there were too many people enjoying subsidized coverage that may or may not have been able to purchase their own medical insurance.
And now hospitals can't afford to treat people who don't have insurance, though they are required by law to do so. According to the director of the Alliance of Massachusetts Safety Net Hospitals, central to the problem is the relatively slow enrollment in Commonwealth Care, the state-subsidized insurance plan for people who do not qualify for Medicaid but cannot afford coverage. Until Commonwealth Care can pick up the slack, hospitals will continue to struggle with the uninsured.
The state is actually trying to assist many of these hospitals, having anticipated a transition period in which adjustments would need to be made in order to accommodate the new Massachusetts health insurance plan. They just have to hope they don't run out of money before medical debt starts to close down hospitals in neighborhoods that desperately need their services.
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