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Massachusetts Still a Leader in Health Care; Federal Proposals Put Successes at Risk

By Nancy Wagman, Kids Count Director, June 13, 2017

Massachusetts ranks 2nd for health in the national KIDS COUNT rankings of the states. But health care achievements and future progress could be at risk if Massachusetts loses funding from the federal government that has been crucial to Massachusetts’ successes. The federal government provides critical funding for health insurance, as well as for a wide range of public and behavioral health programs. More than $10.4 billion of the state’s $44.6 billion budget comes from the federal government to help pay for health care. These funds provide essential health insurance, nutritional support for pregnant mothers and babies, crucial prevention and treatment for substance use disorders, and other protections to keep children healthy. Proposed repeal of the Affordable Care Act, dramatic cuts to Medicaid, and other proposals in the President’s budget could cut several billion dollars from the state budget within several years, and could profoundly affect Massachusetts’ ability to ensure that every child in the Commonwealth grows up healthy.

The Rankings

Tied for #1 in Health Insurance Coverage

Almost every single child in Massachusetts (99%) has health insurance. Massachusetts’ continuing investment—in partnership with the federal government—has been central to this success in providing access to affordable and comprehensive health care as close to half of all children in Massachusetts receive health insurance through the state’s Medicaid (MassHealth) program.

#3 in Child and Teen Death Rate

Massachusetts continues to rank well in the child and teen death rate. In 2015, the death rate was 17 out of 100,000 children ages 1 to 19. This rate has been stable over the past 5 years.

Tied for #5 in Least Alcohol and Drug Abuse

Data show that 5% (25,000) of Massachusetts teens had abused alcohol or drugs in the prior year. These national data are several years old, and do not reflect recent trends in opioid use. The most recent data from the state Dept. of Public Health noted that there were 151 confirmed opioid-related deaths of persons under age 25 in 2016. This was 18% of the deaths of people that age.

#19 in Percent of Low Birth Weight Babies

In Massachusetts, 7.5% of babies are born at a weight of 5.5 pounds or less, putting them at greater risk for a variety of developmental problems. Making sure that pregnant women have access to affordable prenatal care, healthy food, stable housing, supports for stopping smoking, and access to behavioral health care if needed, are all crucial to helping ensure that every baby starts life with a healthy birth.

The federal government is a key partner for the state in supporting programs that help keep Massachusetts children healthy. Cuts to these programs could have lasting effects on Massachusetts’ children.

  • The state receives more than $9.8 billion in federal funds for Medicaid (MassHealth), supporting affordable health insurance for low-income families. Proposed repeal of the Affordable Care Act’s Medicaid expansion could put more than $1.1 billion at risk in Massachusetts by 2021. The proposal to turn Medicaid from an entitlement to a per capita cap and additional funding cuts in the President’s budget proposal would cut even more. Altogether, these could amount to an estimated 45% reduction in federal funds for health insurance by 2026 (over $4 billion each year). Federal revenue cuts this large would put enormous pressure on the state, potentially leading to cuts throughout the state budget.
  • The Children’s Health Insurance Program (CHIP) grant brings $569 million in federal revenue to support health insurance for approximately 169,000 low-income children and pregnant women who are not eligible for Medicaid. Repeal of the Affordable Care Act and passage of the American Health Care Act as currently proposed would cut the CHIP grant by $149 million. Furthermore, the President’s budget proposal would limit CHIP eligibility to 250% of the federal poverty level. (Massachusetts currently covers people up to 300%.)
  • A wide variety of public health programs are in place to support a healthy pregnancy and birth, and many of these rely on federal funding. In particular, $111 million in federal funds supports the Women, Infants, and Children Nutrition (WIC) Program, providing nutrition and health education, healthy food, and other services for low-income, pregnant women. A portion of the $11 million from the maternal and child block grant explicitly provides federal dollars to help care for women during pregnancy. The President’s budget proposal does not target these programs for cuts.
  • Massachusetts also receives more than $124 million in federal funds for community health centers, $47 million in federal funds for local substance abuse prevention and treatments, $10 million for community mental health services, and numerous other grants for health care, mental and behavioral health, preventive health care and public health—all part of the supports that help keep the state’s children healthy.

To see what works to improve health for our children, see MassBudget’s Children’s Budget and Race to Equity.