An article published Dec. 13 in the New England Journal of Medicine takes a look at Massachusetts’ recent efforts to reform health care on a state level.
The proposed reforms, according to the article’s authors, Benjamin Sommers and Aaron Kesselheim, could have “far-reaching implications.”
” … (Massachusetts) has applied for a waiver from federal rules in order to shift 140,000 near-poor adults — those with incomes between 100% and 138% of the federal poverty level — from Medicaid into private plans on the state’s health insurance marketplace and, perhaps more important, to create a closed drug formulary for Medicaid, which would be a first for the program,” the authors write.
The shift from Medicaid to private plans are not unprecedented, according to the article, citing Arkansas’ and New Hampshire’s implementation of a similar approach. Other states have also proposed comparable policies.