The Childrens Medical Security Plan (CMSP) Legislative Report for the fourth quarter of Fiscal Year 2025 indicates that as of June 2025, there were 85,222 children eligible for the program, which provides access to primary and preventive health care services for children and adolescents who are not eligible for other MassHealth benefits and are uninsured. Effective January 1, 2025, the bill established that enrollee premiums would be set at zero for those with incomes up to 300% of the Federal Poverty Level (FPL), while a sliding scale for premiums would apply to those with incomes above that threshold. Additionally, all copayments for CMSP members were eliminated.
The report details the spending breakdown for CMSP during the fourth quarter, with total expenditures amounting to $10,025,194. This includes $8,137,221 for medical claims, $1,689,009 for dental claims, and $198,965 for pharmacy claims. The total number of claims filed during this period was 148,820, comprising 105,562 medical claims, 32,459 dental claims, and 10,799 pharmacy claims. The report also highlights enrollment demographics, showing a decrease in eligible children from 84,768 in April 2025 to 83,293 in May 2025, before rising again to 85,222 in June 2025.