Massachusetts Can't Say How Many $100,000 Earners on Health-Care Dole

July 7, 2008 - 8:24 PM

(CNSNews.com) - Massachusetts provides state-subsidized health care for families with incomes up to $106,812 under the most recent adjustments made to the plan this month, but Massachusetts officials do not know how many people earning that much, or any other amount, are receiving subsidized care.

The state denied a Freedom of Information Act request from Cybercast News Service to specify how many people making $80,000 a year or more received government-subsidized insurance. In several follow-up questions since mid-February, a state spokesman has repeatedly said the state does not know.

"We do not track and do not know how many people earning over $80,000 a year are on Commonwealth Care, because it's irrelevant," Richard Powers, spokesman for Commonwealth Health Insurance Connector Authority, told Cybercast News Service.

Powers explained that people earning up to 300 percent of the federal poverty level are eligible to be covered by the Massachusetts subsidized plan.

For a family of eight, that would be an annual income of $106,812. A family of seven earning $96,012, a family of six earning $85,212, and a family of five earning $74,412 would also be eligible for the taxpayer-financed health care. Under the formula, an individual can earn up to $31, 212 and get the coverage.

"We get the income of any person who applies and use it as a factor in determining eligibility," Powers said. "Once that is done, we track them by federal poverty level, not income, because it is the FPL [federal poverty level] that is used to determine how much they would pay in the Commonwealth program."

The Massachusetts health care plan is broken up into five different "plan types." The first plan type is for those below 100 percent of the poverty level, ranging from an individual making up to $10,404, to a family of eight making $35,604.

Plan type five is the highest, with income earners making between 250 percent and 300 percent of the federal poverty level, which maxes out at $106,812. See income guidelines

The state's health care plan, passed by the Legislature and signed by then-Gov. Mitt Romney in 2006, is now expected to exceed state budget estimates by $400 million in 2009 or about 85 percent higher than projected.

The state's health care plan, which mandates that every state resident that can have health insurance get health insurance, either public or private, was a central point of Romney's failed bid for the Republican presidential nomination, though Romney said he did not want a national mandate for health care.

The Massachusetts plan has also been cited as a possible national model by Democratic candidates Sen. Hillary Clinton of New York and to a lesser degree by Sen. Barack Obama of Illinois.

State officials anticipated about 140,000 people would join the new plan.

But 293,000 did so, the bulk of them signing up for state-subsidized health insurance, which has boosted the estimated costs of the program: 168,924 are enrolled in the state-subsidized program Commonwealth Care; 70,000 more have enrolled in Medicaid; while just 63,000 have enrolled in private plans, according to Commonwealth Connector.

Among those enrolled in the public plan, 3,920 are on the highest income plan (ranging from $31,212 for an individual to $106,812 for a family of eight), and 13,663 are on the plan type for incomes ranging up to $26,016 for an individual and up to $89,016 for a family of eight.

Among those between 150 percent and 200 percent of the federal poverty level, 24,531 are enrolled in some form of taxpayer-financed insurance. This range is for individuals earning up to $20,808 and up to families of eight earning $71,208.

The vast majority of people on the plan, however, are in the lower income level. About half - 89,934, - are under 100 percent of the federal poverty level.

For an individual, that is $10,404, with the maximum family of eight earning $35,604. About half as many - 41,876 - are between 100 percent and 150 percent of the federal poverty level, ranging from $15,612 for an individual to $53,412 for a family of eight. See Chart

Allowing higher income earners to get on state subsidized health care is not going to have long-term benefits for either the insurance market or the state budget, Gracie Marie Turner, president of the Galen Institute, a think tank that focuses on free market solutions to health care, said in an interview.

"The higher you go up the income categories, the more likely you are to crowd out private coverage with publicly subsidized coverage," said Turner, a board member of the Business & Media Institute, a division of the Media Research Center, which is the parent organization of Cybercast News Service.

"Taxpayers have to ask, do we want to be subsidizing health insurance for people who very likely could otherwise afford it?" said Tuner.

"If they're not being more discerning in making sure that people who are the most needy are the ones getting the most help in purchasing insurance, then I think they're not abiding by both the law and the spirit of the legislation," she said.

Make media inquiries or request an interview with Fred Lucas.

Subscribe to the free CNSNews.com daily E-brief.

E-mail a comment or news tip to Fred Lucas.

Send a Letter to the Editor about this article.