Welfare Healthcare Program Hits Maximum Enrollment: Director Lauds it as "Success" and Seeks to Grow Program
       Beginning this week, low-income, unemployed residents eligible for health insurance coverage under a state Medicaid program will be told they’ll have to wait as the program hits its enrollment cap, state health officials said Friday.
       According to a letter sent to the Legislature’s Ways and Means Committee from state Medicaid Director Beth Waldman, the MassHealth Essential caseload is on track to reach its 44,000-person cap by early next week. It’s the second time the insurance program has reached its limit since last December.
       In her letter, Waldman points to the Executive Office of Health and Human Services’ new “Virtual Gateway” online application service as a catalyst for the increased enrollment in MassHealth Essential, and other government assistance programs.
       More than 3,000 applications for health care coverage and other assistance for low-income residents are processed through the gateway each day, HHS spokesman Richard Powers said. Ninety-seven percent of the applications are for MassHealth or the so-called state-administered free care pool, which reimburses health care providers who treat the uninsured and underinsured.
       “Even assuming there was no federal enrollment limitation in place, levels are now reaching the point at which the state legislative language requires a waiting list,” Waldman wrote. “As a result of our success, by the beginning of next week, MassHealth will begin to maintain a waiting list of eligible applicants. MassHealth will regularly assess enrollment in the program and enroll eligible members from the waiting list in the order they applied.”
       MassHealth Essential was created in the fiscal 2004 budget, and began enrolling members in October 2003, with an initial limit of 36,000
individuals. By the end of last year, the program had reached capacity. In January, the state was granted a federal waiver to enroll 8,000 more people.
       In it’s budget proposal now being negotiated with the House, the Senate added an additional $32 million to the program in order to enroll 10,000 more individuals. The House did not add money in its spending plan. Even if budget conferees approve the additional funds, lawmakers would need to receive another federal waiver to raise the limit. And the cap could not be lifted until the budget is signed into law – the new fiscal year begins July 1. Powers said the administration awaits direction from the Legislature. The program is currently funded at about $120 million.