You can change the world just by sharing your story.
~ Barack Obama
Since the advent of language, storytelling has been central to the human experience across time and cultures. Stories entertain and educate; they are vital in advocacy. In defending Medicaid from drastic cuts, stories are a vital instrument because they provide a way to connect people to policy in concrete and compelling ways. Many advocates across the country are leaning into storytelling to protect Medicaid.
Be sure to connect with the MassHealth and Health Connector members you work with or have worked with and encourage them to share their stories, anonymously if preferred. Send those stories to MLRI’s Health Unit for our Medicaid defense work locally and nationally with partners.
Topics for this week’s Health Announce:
- Healthcare Work Group – change of date to Wednesday, April 30, 2025.
- This week – Elder Benefits Training this Thursday, April 17, 2025.
- CMS letter to state Medicaid Directors threatening coverage for gender-affirming care for minors.
- CCA Update
- Check out HCFA’s Lunch and Learn Series!
Be well,
The Health Law Unit
Massachusetts Law Reform Institute
1. Healthcare Work Group – change of date to Wednesday, April 30, 2025.
The HCWG has been pushed back a week to Wednesday, April 30, 2025 from 3 pm – 4:30 pm. Look for the updated Zoom invitation soon. At the next meeting, Linda Landry from the Disability Law Center will speak with us about all the federal developments and changes affecting the Social Security Administration (SSA). If you have any questions specific to SSA, or any other topics you’d like on the HCWG agenda, please send them to me (jkaplan@mlri.org).
2. This week – Elder Benefits Training this Thursday, April 17, 2025.
This Thursday, April 17, 2025, from 9:30 am – 4:00 pm in person at the MCLE Conference Center and via live webcast, MLRI is chairing an Elder Benefits Program. The training covers basic eligibility rules for cash benefit programs like SSI and Social Security Insurance benefits, home-based care services from the Office for Aging and Independence, health care programs like Medicare and MassHealth, and other public benefits available to older adults in Massachusetts. Faculty include experts from MLRI, GBLS, SCCLS, CLA, AGE, and DLC. Special rates are available for legal services attorneys. Register here.
3. CMS letter to state Medicaid Directors threatening coverage for gender-affirming care for minors.
Last Friday, April 11, 2025, the Centers for Medicare and Medicaid Services (CMS) sent a letter to all state Medicaid Directors on the issue of “puberty blockers, cross-sex hormones, and surgery related to gender dysphoria.” While not directly forbidding Medicaid payments for gender-affirming care for minors, the letter lays the groundwork for future CMS action against states under current law.
The letter from Deputy Administrator and Director Drew Snyder aims to undermine the validity of a broad array of gender affirming care interventions and then to use that position to cast doubt on the legality of Medicaid funds being used for such care. For example, the Deputy Director directly claims that hormonal and surgical interventions to treat gender dysphoria cause long-term and irreparable harm in some children. The letter then cites sections of the Social Security Act requiring that Medicaid payments be consistent with quality of care, section 1902(a)(30)(A), and that covered care and services be provided in a manner that is in the best interest of beneficiaries, section 1902(a)(19) – thus arguing that certain treatments for gender dysphoria in children would not comply with those provisions of federal law. Finally, CMS “encourages” state Medicaid Directors to review programs to “ensure alignment with current medical evidence and federal requirements.”
While the CMS letter does not threaten any imminent action, the implication is clear: CMS is laying the groundwork to prevent gender-affirming care for children from being covered by Medicaid. But the harm to the LGBTQ+ community from this letter is also instant. The letter provides cover to conservative states to immediately drop gender-affirming care for minors from their Medicaid coverage. In fact, seeing the writing on the wall, some providers in those states are already pulling services: Planned Parenthood Arizona paused all gender affirming care services in response to the CMS letter.
4. CCA Update
As explained in the March 25, 2025 Health Announce, Commonwealth Care Alliance (CCA), a Massachusetts insurer and medical services plan, was experiencing significant financial difficulty requiring a freeze in enrollments for their Senior Care Options and One Care programs and threatening access to care for nearly 50,000 MassHealth members. On April 9, 2025, an Ohio-based nonprofit, CareSource, announced the purchase of CCA.
CareSource will increase CCA’s cash reserves by $400 million to bring it up to required levels, thus allowing the enrollment freeze in CCA’s SCO and One Care plans to be lifted. CareSource will also take over the CCA home-based primary care practices in Boston and Springfield.
5. Check out HCFA’s Lunch and Learn Series!
Health Care for All (HCFA) hosts a training and discussion series called Lunch and Learn on a variety of topic related to health care access and coverage. Upcoming events include:
- May 15 – MassHealth for Children, Teens and Young Adults: presenting policies, programs and services designed for this population.
- June 12 – MassHealth Accountable Care Organization Program: providing an overview of ACOs and programmatic structure and goals.
Register here.
