Massachusetts health leaders scramble to prevent 300,000 from losing Medicaid coverage

Derek Winbush, 63, of Boston, worries about the coming work requirements. He is part of a large population of people with chronic health conditions who are too unwell to work steadily but don’t qualify for a disability exemption.Winbush has cirrhosis, kidney disease, nerve damage in his feet, vision problems, vertigo, and is HIV positive. He’s the kind of person whose Medicaid coverage may hinge on what is considered medical frailty.

Winbush doubts he would be required to work to maintain coverage, but if he were, he would lose his insurance. His health issues would make it impossible for him to hold down a job, he said. And his health would almost immediately decline without coverage. He takes 11 pills a day to manage his conditions, he said, and has doctor appointments every month.

“It’s probably life or death with me,” he said. “It’s that serious.”

As a volunteer board member for Boston Health Care for the Homeless, Winbush stays informed about Medicaid policies. Many of the people most vulnerable to losing their coverage next year — people living with homelessness or addiction, most of whom suffer from mental health conditions — are completely unaware of the major changes less than a year away, he said.

“They don’t have a clue,” Winbush said.

MassHealth is preparing an outreach campaign this summer, including a new website that will give Medicaid members details about eligibility. Some of the people Winbush described will require direct outreach and assistance, but the work will be infinitely easier if the state can automate many eligibility checks.