Massachusetts could face a $147 million funding shortfall by the end of this fiscal year if enrollment in Commonwealth Care continues at a higher-than-expected rate, the Boston Globe reports. Commonwealth Care provides comprehensive health coverage to people who do not have access to insurance through their employers and who have incomes less than 300% of the federal poverty level. The state fully or partially subsidizes premiums for Commonwealth Care beneficiaries based on income, and beneficiaries are required to contribute copayments for services.

The state had set a goal of enrolling 136,000 people in the program by June 30, 2008, but since October 2006, 133,000 people have enrolled in Commonwealth Care. If the current pace continues, enrollment could reach 178,280 by June 30, 2008, and cost the state $619 million. The state budgeted $472 million for the subsidized program this fiscal year based on previous enrollment estimates.

If the state faces a budget shortfall, then Leslie Kirwan, secretary of administration and finance and chair of the Commonwealth Health Insurance Connector Authority, could shift funds from the $448 million Health Care Safety Net Trust Fund to close the gap. However, some health care providers question whether the safety net has been adequately funded. Kirwan indicated that the state would not seek enrollment caps. "It's too early to make any departure from the health reform plans," Kirwan said, adding, "We will follow the trends and adjust, if needed."

Connector CFO Patrick Holland, who compiled the new data and estimates, said that average monthly medical costs incurred by Commonwealth Care beneficiaries were lower than expected (Dembner, Boston Globe, 11/18).

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