Free Care Pool
Prior to the passage of Chapter 58, the uninsured had a safety net for seeking medical care, commonly known as the “Free Care Pool”. The Uncompensated Care Pool was created in 1985 as a means of paying for medically needed service provided by hospitals and community clinics and health facilities to uninsured and underinsured low-income residents up to 200% of the poverty line. The Free Care Pool also provided partial uncompensated care to individuals between 200% and 400% of poverty, and aided individuals of any income level in cases of extreme medical hardship or debt.

Health Safety Net
Under Chapter 58, the Health Safety Net was created as a successor to the Free Care Pool. It was implemented on October 1, 2007. Like the Free Care Pool, the Health Safety Net covers medically needed services to those who are not eligible for health insurance and cannot afford to purchase it under the individual mandate. The Health Safety Net has provided care to many who once relied on the Free Care Pool. However, differences between the plans mean that some consumers of subsidized health care are no longer covered under the new plan, or must contribute more fees to their healthcare, which can make needed services less affordable. The Uncompensated Care Pool’s safety net which aided so many has been put in danger by this new law.

Differences Between the Plans - Consequences of Chapter 58:

• Subsidies for low-income residents in Massachusetts are less generous under Chapter 58 than they were for uncompensated care. Prior to the passage of the bill, individuals up to 200% of the poverty line received free care through the Free Care Pool. Under Commonwealth Care, however, only individuals up to 150% of poverty receive care with no premiums.
• The free care pool had no cost-sharing (co-payments and deductibles), while Commonwealth Care does. These fees make care less affordable for some.
• Some have benefited from the new law, as in parts of the state, there were few Free Care providers. Under Commonwealth Care, it is easier for some to find medical care providers.
• The new law cannot be funded, as suggested, through the Free Care Pool. Funds are simply inadequate to achieve this goal.

Other Resources:
Health Safety Net Information

• “Health Safety Net: An Overview,” MassResources.org, July, 2008.

Free Care Pool

• “Massachusetts Uncompensated Care Pool,” Division of Healthcare Finance and Policy, November, 2005.
• “Groups Ask Romney to Postpone Free Care Pool Changes,” Healthcare for All, August, 2005.
• “What’s Next for the Uncompensated Care Pool?” Nancy Turnbull, May 2007.

General Info from mass.Gov

• “Uncompensated Care Pool,” Office of Health and Human Services, 2008.