Jobless turn to health lifeline

Thousands flood state program Plan helps with insurance costs

The economic crisis has produced a tsunami of newly unemployed Massachusetts residents seeking financial help with health insurance coverage.

Over the past three months, so many people have signed up for the Medical Security Program, a lifeline that helps middle-and lower-income unemployed residents pay their health insurance premiums, that participation is 73 percent higher than a year ago.

Funded by a tax on employers, the state program pays 80 percent of a laid-off worker's monthly health insurance premium for almost a year. For those who can't afford to keep their previous insurance, even with the subsidy, the program provides basic health coverage and charges recipients modest copayments of about $15 for a doctor's visit.

"The calls are increasing even as we speak," program director Wendy Hamlett said last week. "We are receiving 200 daily applications, on average. Five months ago, we were getting about 75 to 100 applications a day."

The unemployment rate in Massachusetts has jumped from 4.1 percent to 5.9 percent over the past eight months. More than 200,000 residents are now out of work as companies ranging from Fidelity to Tweeter slash jobs or shut down.

Without work, people lose their employer-paid health insurance and are often left scrambling to find coverage. Some are fortunate and can join a spouse's insurance plan. Other alternatives include continuing with their existing health plan but paying much higher monthly premiums through a program known as COBRA - though the Medical Security Program can help with these higher payments. Lower income people can sometimes qualify for coverage through Medicaid. And there also are state subsidized programs created under Massachusetts' 2006 mandatory insurance law.

Pepperell truck driver Shawn Bevis will soon be confronting these choices. Laid off from DHL in mid-November, his company-paid health insurance runs out in February.

"I am sure they will offer us COBRA, but whether I can afford it or not, I don't know," said Bevis, 37, who is collecting unemployment but was unaware of the Medical Security Program.

Bevis has lined up a part-time job teaching driver's education starting next month, but that doesn't come with health insurance. Now, the married father of two teenagers is considering going without insurance, which would make him subject to a hefty tax penalty because state law requires most people to have coverage or pay a fine.

"When it comes to myself, I don't worry too much about insurance because I rarely get sick," he said. "And I will look into (Medicaid) for my wife and kids if it comes down to it."

As the newly unemployed try to piece things together, help-line counselors at Health Care for All, a statewide consumer group, are reporting a surge in the number of residents calling about health insurance coverage. The number of weekly calls to the help line this month is running about 56 percent higher than earlier this year. For the first week of December, the organization reported 1,096 calls to the line.

"People have contacted unemployment and have not been able to get through at all, and when they have, they sometimes haven't been given information about the Medical Security Program," said Health Care for All counselor Hannah Frigand.

The medical program is run by the same state office that administers unemployment, and Hamlett said that every applicant who files for unemployment is mailed an application and brochure about health coverage.

Unlike other state-run health insurance that is geared to lower-income residents, the Medical Security Program is open to people who have been making heftier incomes. Eligibility is calculated by adding a family's income for the six months prior to an applicant's unemployment to projected income for the next six months. The total annual income can not exceed 400 percent of the federal poverty level, which translates to as much as $84,800 for a family of four.

As many companies shed workers, the Medical Security Program is hiring help to deal with the onslaught. Still, Hamlett said, the waiting time for processing paperwork is running about two weeks and growing. Staff members often try to slice through the backlog, she said, by asking people who desperately need medical attention to fax their paperwork to the office instead of mailing it.

Created 20 years ago under the administration of Governor Michael S. Dukakis, the Medical Security Program is unique to Massachusetts. Health coverage under the program ends when a recipient's unemployment benefits are exhausted. But federal lawmakers this year have twice extended the limits for collecting unemployment, so Massachusetts residents can now remain in the Medical Security Program for up to 46 weeks.

As of the end of November, just over 13,000 laid-off workers and their dependents were enrolled, up from 7,710 a year ago, and officials say that number is quickly rising.

That has raised concerns about the program's solvency, especially because Governor Deval Patrick earlier this year tapped $35 million from the program's reserves to plug a gap in funding the state's landmark healthcare law.

There was $71.8 million left in reserves as of the end of November, Hamlett said, an amount that is expected to keep the program afloat for another year.

Other state-run health insurance programs are not reporting nearly as many new people knocking on their doors.

Enrollment has been relatively flat in Commonwealth Care, which is state-subsidized coverage for people who make under 300 percent of the federal poverty level but don't qualify for Medicaid and don't have access to insurance through employment.

Commonwealth Choice, a smorgasbord of brand-name plans assembled by Massachusetts health reformers for people who make too much to qualify for subsidized coverage, has shown only modest increases. But officials are stepping up marketing of the plans as more affordable alternatives to COBRA, said Dick Powers, spokesman for the Connector, the state agency that runs Commonwealth Choice.

A national survey released earlier this month by the Kaiser Family Foundation, a California-based nonprofit, found that most who lose their jobs can't afford the premiums to continue through COBRA. Federal law requires most companies to offer laid-off workers the right to continue their healthcare coverage, but employees bear the entire cost of the monthly bills because their former employer no longer pays its share of the premiums.

The Medical Security Program's telephone number is 1-800-908-8801; its website is dwd-webapp-01.detma.org/oldsite/WSmsp.htm

Kay Lazar can be reached at klazar@globe.com.