Massachusetts
Families, physicians fear what Medicaid cuts could mean for children in Massachusetts – The Boston Globe
Now, parents, policy makers, and health providers are holding their breath as Republicans in Congress weigh potentially billions of dollars in cuts to Medicaid. Federal dollars pay for more than half of MassHealth’s $20 billion annual budget.
“MassHealth is a cornerstone for children’s health in Massachusetts,“ said Katherine Howitt, director of the Massachusetts Medicaid Policy Institute, an independent policy analysis program of the Blue Cross Blue Shield of Massachusetts Foundation.
The consequences of significant cuts to Medicaid, and the potential for voter outrage, have some doubtful Congress will ultimately cut from the public insurance program.
The information coming out of Washington is too vague to act upon, said Mike Levine, assistant secretary for MassHealth.
“We do not have specific contingency plans around what services we offer kids and what we might do if Congress or CMS takes actions we don’t like,” he said in an interview Monday.
Still, the possibility frightens Bernard. When her daughter, Victoria, was 2, before doctors had figured out what prescriptions and dosages would best control her epilepsy, she routinely had multiple seizures a week, her mother said. The child’s speech is delayed, but with the therapy MassHealth pays for, she is learning to express herself verbally.
“Without MassHealth I don’t know how I would do,” Bernard said. “I’m very concerned about it.”
Congressional Republicans have said they want to balance tax cuts by, in part, eliminating $880 billion in federal spending over 10 years. Leading Republicans, including President Trump, have said that won’t include cuts to Medicaid benefits. US House Speaker Mike Johnson has said his party is seeking only to reduce “fraud, waste, and abuse.”
But experts on health policy say there’s no way Republicans can achieve their budget goals without impacting Medicaid. At more than $600 billion a year, the program is among the federal government’s largest expenses.
“We know that the only way to achieve $880 billion in cuts is through catastrophic cuts to the Medicaid program as we know it,” said Megan Cole Brahim, a Boston University professor and co-director of the school’s Medicaid Policy Lab. “There’s really no way it wouldn’t have harmful implications for children.”
Massachusetts expanded MassHealth in 2006 to include children in households earning up to 300 percent of the federal poverty level, extending coverage to more children than in all but a few states.
As of 2023, only 0.6 percent of Massachusetts children were uninsured, according to a report from the state Center for Health Information and Analysis on insurance coverage in the state.
The state’s post-pandemic review of MassHealth eligibility led to about 363,000 people removed from membership last year, including almost 59,000 children ages 17 and younger, the state reported.
Even if Congress took a hatchet to Medicaid, Cole Brahim said she anticipated Massachusetts would seek to protect children from the brunt of the consequences. Officials could be forced to reduce access to some optional benefits, such as physical therapy, case management, and community health workers, and could reduce the kinds of prescription drugs, or the dosage amounts, covered by MassHealth.
Losing even partial Medicaid reimbursements would be devastating to community health centers and hospitals. On average, the health centers receive about 31 percent of their revenue from MassHealth, according to the Massachusetts League of Community Health Centers. MassHealth paid about 18 percent of all hospital revenue in the state as of 2022, according to the Blue Cross Blue Shield of Massachusetts Foundation. Boston Children’s Hospital reported roughly 46 percent of its Massachusetts patients are MassHealth members. Substantial cuts to Medicaid, hospital officials said, would create financial aftershocks that would affect every patient in the hospital.
“The danger for any children’s hospital in the country, [if] you start cutting Medicaid, you’re going to affect care delivery for every patient,” said Joshua Greenberg, Boston Children’s vice president of government relations.
On Monday, Governor Maura Healey and her partner, Joanna Lydgate, toured Children’s to highlight how potential cuts to Medicaid, as well as halts to millions in National Institutes of Health research grants, could affect patients. Kevin B. Churchwell, the hospital’s president and chief executive, said federal funding cuts have already disrupted clinical trials and research, including work with vaccines.
“We have patients in clinical trials who had their treatments stop because of this,” Healey said. “Can you imagine the cruelty of that?”
Among the groups Medicaid supports, including seniors and some people with disabilities, children are a relatively inexpensive clientele. They account for about 16 percent of the state’s total MassHealth expense. The families of some children enrolled also have private insurance but rely on MassHealth as secondary coverage to help with medical-related bills their insurer doesn’t cover.
For many children, MassHealth membership means more than covered doctor visits. The program pays whatever is needed to ensure children with disabilities have the equipment, care, and support they need. It allows children to receive Medicaid-covered services through their school’s health services and pays for behavioral health care in the community or home.
In addition, families on MassHealth get screenings to identify dental, aural, visual, or developmental concerns. Such wide-ranging and widely accessible insurance coverage can benefit children their whole lives. Children with good health care do better in school, a 2021 Blue Cross Blue Shield of Massachusetts Foundation report stated, and those with access to Medicaid tend to have fewer hospital stays, emergency room visits, and chronic conditions in adulthood.
Victoria Bernard’s doctor, Laura Livaditis, director of pediatrics at Mattapan Community Health Center, said about 90 percent of the children treated at the center are enrolled in MassHealth. Most of her patients are also from families living at or below the poverty line. MassHealth’s wide-ranging coverage has helped them to avoid evictions, she said. And for immigrants, the program has helped them make connections to ensure they have stable food and housing.
“I’m continuously impressed with the breadth and depth of services MassHealth covers for my patients,” Livaditis said. “I can’t remember the last time I had to fight with [MassHealth] insurance for needed services.”
Correspondent Emily Spatz contributed to this report.
Jason Laughlin can be reached at jason.laughlin@globe.com. Follow him @jasmlaughlin.
Police shot and killed a man who officials say rushed officers with a knife during a call in Lexington, Massachusetts, on Saturday.
Middlesex County District Attorney Marian Ryan said the situation started around 1:40 p.m. when Lexington police received a 911 call from a resident of Mason Street reporting that his son had injured himself with a knife.
Officers from the Lexington Police Department and officers from the Northeastern Massachusetts Law Enforcement Council (NEMLEC), who were already in town for Patriots’ Day events, responded to the call.
Police were able to escort two other residents out of the home, initially leaving a 26-year-old man inside. According to Ryan, while officers were setting up outside, the man ran out of the home and approached officers with a large kitchen knife.
She added that police tried twice to use non-lethal force, but it was not effective in stopping him. The man was shot by a Wilmington police officer who is a member of NEMLEC. The man was pronounced dead on scene and the officer who fired that shot was taken to a local hospital as a precaution.
The man’s name has not been released.
Ryan said typically in a call like this where someone was described as harming themselves, officers would first try to separate anyone else to keep them out of danger, which was done, and then standard practice would be to try to wait outside.
“It would be their practice to just wait for the person to come out. In the terrible circumstances of today, he suddenly rushed the officers, still clutching the knife,” Ryan said.
The investigation is still in the preliminary stages and more information is expected in time. Ryan said her office will request a formal inquest from the court to review whether any criminal conduct has occurred, which is the standard process.
This happened around the same time as the annual Patriots’ Day Parade, and just hours after a reenactment of the Battle of Lexington, which drew large crowds to town.
This is a developing story. Check back for updates.
Massachusetts
‘An impossible choice’: With little federal help to combat rising costs, Head Start looks to Massachusetts for more help – The Boston Globe
In Massachusetts, roughly 1,300 slots for children across Head Start’s 28 agencies have been eliminated in the last three years because federal funding has plateaued over that time, while the cost of running the program continues to rise, according to the Massachusetts Head Start Association. Nationally, Head Start enrollment dropped from 1.1 million kids in 2013 to around 785,000 in 2022, according to research by the Annie E. Casey Foundation.
“If they didn’t get into a Head Start program, they would be sitting at home,” said Brittany Acosta, a Head Start parent in Dorchester.
It’s teachers are drastically underpaid, and there’s a serious need for a rainy day-type fund should the federal government shut down again, the association says. As they’ve done in years past, state lawmakers have offered to provide financial relief, but the Massachusetts Head Start Association’s request for 3 percent above the amount it received last year, an additional $4.6 million to help its staff keep up with the state’s rising cost of living, so far has not been allocated.
Last year, President Trump’s leaked budget proposal revealed he considered eliminating Head Start entirely. Then, in the summer, he cut off Head Start enrollment for immigrants without legal status. And during the fall’s government shutdown, four Head Start centers in Massachusetts closed because they couldn’t access their funding.
Trump’s latest budget proposal shows a fourth year without increasing funding for the program, which was established in the mid-1960s.
Michelle Haimowitz, executive director of the Massachusetts Head Start Association, said the program doesn’t want to eliminate more child slots than it already has, but paying teachers a competitive salary is equally important in order to keep them from leaving for higher paying jobs. Head Start teachers make under $50,000 annually compared to over $85,000 for the average Massachusetts kindergarten teacher.
“It’s an impossible choice,” Haimowitz said. “When we reduce the size of our programs, we’re not reducing the size of the need.”
Massachusetts is one of few states that supplements federal funding for Head Start, and last year it increased the program’s state grant from $5 million to $20 million, adding to the $189 million in federal aid it receives in this state.
“We can’t run a program without giving staff a raise for three years,” Haimowitz said. “Our next fight now is not just for survival, but it’s for thriving and growth.”
The Massachusetts House Ways and Means Committee on Wednesday released its budget, which doesn’t grant Head Start’s request of a 3 percent boost. But state Representative Christopher Worrell filed an amendment for additional funding. Worrell, whose district covers parts of Dorchester and Roxbury, said he loves Head Start’s embrace of culture, recalling one visit to a center where he could smell staff cooking stew chicken, a traditional Caribbean dish.
“I’ve been to dozens of schools throughout the district, and you don’t get that home-cooked meal,” Worrell said. “[The state is] stepping up and doing the best we can with what we have.”
At the Action for Boston Community Development’s Head Start and Early Head Start center in Dorchester, the children of Classroom 7 arrived one Monday morning and dove into bins of magnetic tiles before their teachers, Paola Polanco and Leolina Rasundar Chinnappa, served breakfast. Acosta dropped off her 4-year-old daughter, Violeta, before reporting to her teaching position at the center, where several other Head Start parents also work.
“It’s important for all Head Start parents to have the opportunity to give their child an experience in a learning environment before they actually start kindergarten,” Acosta said.
Beyond providing early education and care to children of low-income families, from birth to age 5, the program helps them access other resources, including mental health services, SNAP benefits, homelessness assistance, and employment opportunities.
It also serves as daycare for parents who might not be able to afford it, while they’re at work.
Research has shown the importance of preschool in a child’s development with one 2023 study, focused on Boston public preschools, finding that it improves student behavior and increases the likelihood of high school graduation and college enrollment.
For Rickencia Clerveaux and Christopher Mclean, the Dorchester Head Start center is the only place they feel comfortable sending their 3-year-old son, Shontz, who is on the autism spectrum. Shontz’s stimming — repetitive movements that stimulate the senses — has reduced, and his speech has improved since he joined the center in 2024, Clerveaux said.
His parents say he’s also come out of his shell. Mclean now drops his son off and gets a simple “bye” as Shontz joins his classmates, he said.
He and Clerveaux said they appreciate the specialized attention Shontz can receive from teachers, such as when staff identified that Shontz might have hearing issues. His parents were able to follow up with their doctor and get Shontz to have surgery to improve his hearing.
“It’s a safe net for parents,” Clerveaux said. “There’s so many ways that him being here helps him grow better.”
Without Head Start, Clerveaux said a lot of pressure would be put on parents to find care for their children, “knowing that they’re already struggling or not getting the ends to meet.”
“That’s a burden for everybody in the community,” she said. “If there’s no funding, there’s no daycare and parents cannot work.”
Lauren Albano can be reached at lauren.albano@globe.com. Follow her on X @LaurenAlbano_.
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