The impact of health care reform on minority populations 
The Massachusetts Health Disparities Council
April 27, 2009

Mission: To promote health care coverage across the state.  

The Connector is accomplishing this mission by:
•	Developing Commonwealth Care:
•	A government-subsidized health insurance for qualified uninsured individuals whose family income is 0% - 300% of FPL.
•	Developing Commonwealth Choice:
•	A non-subsidized health insurance for small groups and individuals.
•	Policy responsibilities:
•	Defining “minimum creditable coverage”
•	Determining “affordability”: In turn determines exemptions from the individual mandate.

Uninsured by Race and Ethnicity by Percent of All Massachusetts Residents in 2007
•	In 2007, the percent of uninsured MA residents that are:
o	Asian Non-Hispanic was 4.5% 
o	White Non-Hispanic was 4.6%
o	Other, multiple was 5.4%
o	Black Non-Hispanic was 7.9%
o	Hispanic was 10.2%
•	In 2007, 5.7% of all Massachusetts residents did not have health insurance. However, Hispanics and Black Non-Hispanic residents have higher rates of uninsurance when compared to other race and ethnicities.

Uninsured by Race and Ethnicity by Percent of All Massachusetts Residents in 2008
•	In 2008, the percent of uninsured MA residents that are:
o	White Non-Hispanic was 2.2%
o	Other Race Non-Hispanic was 2.8%
o	Hispanic was 7.2%
•	The total population was 2.6%
•	With an uninsurance rate more than twice as high as non-Hispanic groups (7.2% versus less than 3%), Hispanic residents of Massachusetts were more likely to go without coverage in 2008. 

March 2009 Enrollment
•	From October 2008 to March 2009, enrollment with no premium members averaged at 120,000, whereas premium-paying members averaged at 42,000 members at an average of 164,000 members, overall. 
Enrollment by Plan Type for March 2009, for a total of 165, 003 members
•	86,542, 53% for Type 1 (0-100% FPL) 
•	33,243, 20% for Type 2A (100-150% FPL)
•	25,010, 15% for Type 2B (150-200% FPL)
•	20,206, 12% for Type 3 (200-300% FPL)

Enrollment History (as of 3/1/09) 
•	Increase in Enrollment starting in December of 2008
•	From November 2006 to March of 2008, new additions (PTIIA Auto-Assignment) and net enrollment peaked at 30,000 in December of 2007. 
•	February of 2007 was the beginning of Redet Closings. 
•	Enrollment dropped, approaching -5,000 from June to November of 2008, then increased toward zero in December.
•	From November 2006 to March of 2008, total Net Enrollment was 1,391; total Closings was 11,099; and total New Additions was 12,490. 

Health Disparities Advisory Committee
•	7 members with representatives from DHFP, DPH, MassHealth, BPHC, an MMCO, and a minority health advocacy organization
•	began meeting quarterly in June 2007

Health Disparities Advisory Committee
•	The advisory committee identified two areas of focus:
•	Race, Ethnicity & Data (REL) Collection
•	Outreach & Communications

Race, Ethnicity & Language (REL) Data Collection
•	Examined REL data in CommCare
•	Examined how different agencies throughout the state are collecting REL data
•	Contributed to the QCC / Brookings Institution’s efforts

Outreach & Communications
•	Quarterly meeting with advocates
•	Participate in MassHealth Training Forums (MTF)  
•	Work closely with EOHHS grant recipients 
•	Work with community-based organizations to create materials for target specific populations
•	E-learning modules (English and Spanish):
•	45 minute web-based modules for CommCare outreach workers and for the general public
•	Connector media placements
•	e.g. TV:  Univision/Telefutura

An example of our outreach and Communications efforts:
Open Enrollment:  May 25 – June 25, 2009
The CommCare program staff going statewide in order to communicate changes:
•	February	
•	Reviewed materials and communication approach with 7 community based organizations 
•	March	
•	Presentation with Mass. League of CHCs
•	Connector workshop w/Network Grantees
•	April 
•	Presentations at statewide MTF sessions
•	May  
•	Western Health Access Network - Amherst 
•	Health Care for All

Outreach & Communications
•	Enrollment Materials
•	Designed by Maximus Center for Health and Literacy
•	Conducted focus groups to ensure accessibility
•	Printed English and Spanish
•	Improvements to our customer call center
•	increased # of bilingual CSRs
•	decreased call wait times
•	Commonwealth Care Fact Sheets
•	Translated to: Spanish, European & Brazilian Portuguese, Vietnamese, Chinese (traditional), Haitian Creole, Russian, Khmer, Lao
•	Download PDFs from:  www.MAhealthconnector.org

Looking ahead
•	Address the newly adopted changes from the QCC
•	Continue to work with other stakeholders
•	community organizations
•	MMCOs
•	health insurers
•	MassHealth
•	Research