The Uncompensated Care Pool — soon to be renamed the Safety Net Care Pool — is central to our health care system for low income people. Our Pool system ideally means that hospitals are not penalized financially for treating a low-income uninsured person, and that low income uninsured people can get care at hospitals and community health centers without regard to their ability to pay. It is our true safety net, the coverage of last resort, for people who would otherwise languish without needed care. The Pool represents the most compassionate aspect of our complex health care system.

Of course, ideal and reality are not always congruent. The previous administration made several attempts to limit Pool services and eligibility. This led the legislature, as part of health reform, to put a freeze on Pool regulations until October 1, 2007. After that, the Division of Health Care Finance and Policy, which administers the Pool, can make changes to eligibility and benefits regulations. The Division will be holding a consultative session on the Pool in 2 weeks, and plans to issue draft regulations in mid-July (a terrific background and summary of the issues was posted by Nancy Turnbull on the CommonHealth blog).

One welcome change was officially announced today. Pool eligibility was extended to people applying to MassHealth who have met all the eligibility requirements except for documenting their citizenship and identity. The MassHealth memo is available here.

Until April, MassHealth was applying the burdensome federal citizenship documentation requirement to the Pool. (This has nothing to do with Pool access for non-citizen immigrants; the requirement only applies to US citizens.) The federal requirement, though, doesn’t apply to the Pool. We applaud the decision to extend the Pool safety net while people are assembling the documents needed to meet the Medicaid and Commonwealth Care rules.

We look forward to working with DHCFP and EOHHS as the state determines if changes are necessary to the Pool benefits and eligibility structure. The ACT!! Coalition hopes to agree on a set of principles to guide our advocacy. Feel free to add your thoughts in the comments.
Brian Rosman