Belated Day 29 and 30- Medicaid at 50: Massachusetts and EPSDT

Once again, I’m a failure at timeliness. Please don’t hold that against me! Without further ado here are your missing posts:

Day 30- Medicaid at 50: EPSDT’s Birthday! 

Ok, this was supposed to be written and put up on July 1st. So let’s pretend it’s July 1st.

The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit is available to all Medicaid eligible children under 21. States are required to provide children with screening services and treat any problems that arise with kids.

Added to the Medicaid program in 1967, just two years after the passage of Medicaid, one of EPSDT’s greatest impacts was that it paved the way for home and community based long-term care services. The program requires that the state provides services to treat the child regardless of whether this is a covered benefit through the Medicaid program. Many children living with disabilities required home services, forcing Medicaid programs to develop contracts with local agencies to provide these services. Remember, back in that time disabled people and seniors were almost exclusively housed in institutions. EPSDT changed that.

Day 29- Medicaid at 50: State Highlights: Massachusetts

Massachusetts covers 1,540,308 people in it’s Medicaid and CHIP programs known as MassHealth.

Massachusetts has always been a leader in the Medicaid program. Their 1115 waiver that changed their Medicaid coverage and private insurance market would give birth to the Affordable Care Act.

The focus in Massachusetts has definitely been on giving access to coverage for low income individuals.  One of the most impressive facts about the state is that, 99.8% of children in Massachusetts have insurance.  But while the state may be close to universal coverage, MassHealth eligibility is not flat:

Screenshot 2015-07-03 12.17.21

Asset tests and complex application processes still exist in the Commonwealth’s program for some populations. So while significant changes have been made, Massachusetts doesn’t have a unique streamlined program with services available to all low-income individuals. More, it is complex, like all state Medicaid programs.


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