Mass. obtains extension of Medicaid waiver

Massachusetts has reached an agreement with the federal government on a three-year extension of a Medicaid waiver needed to provide critical funding for the state's landmark health care law.

Gov. Deval Patrick said Tuesday the agreement secures billions of dollars more in spending authority for the state over the previous waiver and preserves existing eligibility and benefit levels already in place for the health care law.

The guaranteed federal funding also removes a large question mark in the state's budget. Massachusetts' health care obligations for the current fiscal year now are fully funded, the governor said.

"Even in these tough times, we cannot abandon our commitment to affordable, accessible, high quality health care for every man, woman and child," Patrick said during a Statehouse press conference.

Sen. Edward Kennedy, who helped broker the deal, said it would enable the state to continue to provide affordable health care to families while building on the law's early successes. He said it would also help make the law a model for the rest of the country.

"We've made major progress in the program's first two years, cutting the number of uninsured in half," Kennedy said in a statement. "Our experience with health reform in the Commonwealth argues well for our debate on national health reform next year."

The waiver allows Massachusetts to bypass rules about spending federal money for Medicaid, a state and federally funded program that provides health care assistance to low-income people. The state needs the waiver to continue using federal money as it shifts coverage from free emergency room care for the uninsured to a mix of private and government-sponsored insurance for all workers.

Under the deal, the state has the authority to spend about $21.2 billion over the next three years on the health care law, a $4.3 billion increase over the previous three-year agreement

The deal also allows the state to continue to offer subsidized health plans under the Commonwealth Care program to adults earning three times the federal poverty level. Children enrolled in the Children's Health Insurance Program whose families earn up to three time the poverty level also will be covered.

Federal negotiators had hoped to drop the eligibility level to two times the federal poverty level.

The agreement comes as Massachusetts continues to see increases in the number of insured residents as it works toward near universal coverage under the law. Between Jan. 1 and March 31, those with insurance increased from 340,000 to 439,000.

A total of 191,000 people have gotten private insurance since the law took effect in June 2006. Another 176,000 purchased subsidized insurance, while 72,000 have been insured through government programs.

Fawn Phelps, interim executive director of the advocacy group Health Care for All said the deal ensures the costs of the insurance program is shared by all parties.

"Consumers stepped up a while ago with copay and premium increases and this is the federal government stepping up," Phelps said.