OK, this is not for the faint hearted. The MA Medicaid Policy Institute has produced a first rate report on “The Role of MassHealth “Budget Neutrality” Requirements in Designing Policies to Expand Health Coverage.” Click here to obtain. What the heck is that all about?
Briefly and simply (I hope), federal Medicaid financing is a key part of maintaining and expanding affordable coverage for the uninsured. Federal rules allow the state to expand MassHealth and obtain federal matching dollars under an obscure “budget neutrality” formula that has real limits on dollars and, thus, potential expansion possibilities. Around town, there has been a considerable amount of disagreement on the “headroom” or allowable expansion that retains federal financing. More headroom = more federal dollars to expand: less headroom = fewer federal dollars, meaning less expansion, or more new state dollars.
This new paper presents the issues in clear, understandable language and is a good explanation of this dense and important topic. Bottom line: Romney folks had suggested the state had additional headroom in the neighborhood of $300 million, and other folks suggested it was more in the range of $1.5 billion. The consensus verdict is around $700 million, better than the original Administration estimate and not as good as the more rosy projections.
And how likely is it that $700 million is the final verdict — completely unknown and unknowable. Enjoy!
