State Health Care Program Faces Budget Gap

The sagging economy is forcing another cut in the state’s effort to provide nearly universal health coverage, Commonwealth Care, which could face a nearly $120 million budget shortfall in the coming fiscal year.

The budget that begins next week assumes the state will provide free or subsidized health coverage for 180,000 residents during fiscal 2010 through Commonwealth Care. But enrollment has been rising so quickly in the last few months that the program has almost hit that mark already, and it is still climbing.

To save money, the state will stop automatically enrolling low-income residents who don’t choose a free plan on their own. The assumption is that the state will save money because these residents won’t re-enroll in Commonwealth Care until they get sick and go to a hospital or their doctor.

In a separate move, the legislature has approved a cut that ends Commonwealth Care coverage for legal immigrants. That change is in a budget bill Gov. Deval Patrick is reviewing.