The opportunity to live a healthy life begins long before a person shows up at the doctor’s office or hospital; health begins where people live, learn, work, and play. There is growing recognition that greater attention to the social determinants of health – things like having stable housing, safe, walkable neighborhoods with accessible transportation, grocery stores with affordable, nutritious options, schools that are equipped to provide high-quality education, and incomes that enable families to make ends meet – is critical to making meaningful improvements to health. This paper briefly examines the health impact of one program that provides economic support for low-income working families: the Earned Income Tax Credit (EITC).
In healthy communities, children are more likely to be born healthy and can grow up to be healthy adults. When people are healthy they are better able to reach their full potential and make lasting contributions to society. Health is influenced by a variety of complex factors, such as where one lives, access to healthy foods, and affordability of health care. Policies that address the ability of workers to care for family members, like Paid Family and Medical Leave (PFML), can also shape and influence health.
New data from the U.S. Census show the results of commitments made by Massachusetts and the nation to improving health care security for our people. The rates of health coverage have increased steadily since the Affordable Care Act was enacted in 2006.
Massachusetts ranks 2nd for health in the national KIDS COUNT rankings of the states. But health care achievements and future progress could be at risk if Massachusetts loses funding from the federal government that has been crucial to Massachusetts’ successes. The federal government provides critical funding for health insurance, as well as for a wide range of public and behavioral health programs. More than $10.4 billion of the state’s $44.6 billion budget comes from the federal government to help pay for health care. These funds provide essential health insurance, nutritional support for pregnant mothers and babies, crucial prevention and treatment for substance use disorders, and other protections to keep children healthy. Proposed repeal of the Affordable Care Act, dramatic cuts to Medicaid, and other proposals in the President’s budget could cut several billion dollars from the state budget within several years, and could profoundly affect Massachusetts’ ability to ensure that every child in the Commonwealth grows up healthy.
Since Medicaid is a partnership between state and federal governments, much of this essential health care coverage is actually paid for by the federal government. The Governor’s proposed Fiscal Year 2018 budget includes approximately $16.6 billion for MassHealth. This total (or gross amount) is approximately 37 percent of total state budget appropriations. The federal government then reimburses Massachusetts for more than half of this spending. After receiving these reimbursements, the state’s net cost for MassHealth is $8.0 billion, 24 percent of the total net budget.
Children in Massachusetts are better off as a whole than children nationally. And thanks to more than a decade’s worth of health reform in Massachusetts, children here are far more likely to have health insurance than children almost anywhere else in the U.S. Even so, close to one in seven children in Massachusetts lives in poverty, and is at risk for a wide variety of lifelong challenges.
Massachusetts is the national leader in providing health insurance coverage to its residents, thanks to health reform measures adopted a decade ago. The state’s health insurance coverage rate in 2015 was 97 percent, up about half a point from 2014. The gap between Massachusetts’ “nearly-universal” health care coverage and fully “universal” health care coverage gets smaller every year.
New Census data released this week shows that ACA implementation led to the largest single-year increase in health insurance coverage nationwide in 2014. Also, incomes in Massachusetts increased and child poverty declined for the first time since 2008. But we have a long way to go. Incomes are barely growing across the country and more than one in five children nationally (and more than one in seven in Massachusetts) lived in poverty in 2014.
This brief describes the “net” cost of MassHealth, providing a much clearer picture of the impact of MassHealth on the state budget rather than looking at gross state budget totals alone.