Uncomfortable Question — What’s Up with the MassHealth Waiver?

Back in January, Gov. Romney and Sen. Kennedy announced they had reached a deal with the federal Centers for Medicare and Medicaid Services (CMS) to renew for three years the MassHealth Waiver that has provided hundreds of millions of dollars to the Commonwealth each year since 1997 to support our health care safety net.

For the narrow band of insiders who follow this stuff, the announcement (in the January 15th Boston Globe) was received with a huge sigh of relief – and a recognition that the broad outlines of the deal left many details of enormous consequence unresolved – details that could throttle the whole deal. The deal was reached with US Health & Human Services Secretary Tommy Thompson literally hours before he headed out the door. His successor, former Utah Gov. Mike Leavitt, was expected to follow a tougher budget line. Still, we had until June 30 until the then-current waiver expired, lots of time for detail ironing.

July 30-July 1 came and went with no word on the waiver. No public announcements, no media accounts. No concerns, folks were assured, just nagging details.

Well, now we’re looking at September 1 and still no deal. And around town, the buzz is growing. Folks who pay attention to these things are increasingly worried the Bush Administration will not agree to essential components necessary to keep the promised federal funds flowing – as much as $583 million per year over three years.

If the deal turns sour, one of the first casualties would be the Romney notion that we can cover all the uninsured with the existing money in the Massachusetts health care system. We’re dubious about that assertion even with the waiver dough. Without it, it’s lights out for RomneyCare.

If you want to know more about the gory details of the waiver, check out this issue brief published last spring by the always-fabulous Mass. Medicaid Policy Institute. Sorry no link to the 1/15/05 Globe article – that requires payment to el Globo.

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