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Massachusetts health care – wonky with a dose of reality

June 16, 2016

Assister helping client with health care enrollment

Last week, the Kaiser Family Foundation (KFF) released the results of its annual survey of enrollment assistance programs nationwide. The report highlights the critical importance of, and on-going need for, enrollment assisters if states want to continue to build on, as well as sustain, gains in insurance coverage. You can read the report here.

Here are some key findings from the report:

  • The need for in-person assistance remains strong and won’t go away any time soon.
    • An estimated 30,400 assisters helped about 5.3 million people during the third Open Enrollment period.
  • A majority of consumers lack confidence to apply for, or to select, coverage on their own.
    • About 8 in 10 assister programs said most to nearly-all consumers sought help because they lacked the confidence to apply for coverage and financial assistance on their own.
    • About eight in ten programs also said most-to-nearly-all consumers needed help evaluating their plan choices.
  • Enrollment assisters play a critical role in consumer health insurance literacy.
    • Most assister programs (61%) said most or nearly all consumers had difficulty understanding basic insurance concepts.
  • There is strong demand for enrollment assistance programs even outside of Open Enrollment.
    • Increasingly, programs are serving a mix of new and renewing consumers – evidence that consumers need help to remain covered, not just to enroll for the first time.

KFF’s report is clear - enrollment assisters are critical in ensuring people get and stay covered in health insurance coverage. Insurance marketplaces’ on-going investment in consumer assistance enrollment programs will help to increase enrollment and keep people covered.

Here in Massachusetts, there approximately 1,700 enrollment assisters, including 10 HCFA staff Navigators, trained and certified to help residents apply for free and lower-cost MassHealth and Health Connector coverage. If you, or someone you know, needs free health insurance help, please contact our HelpLine at 800-272-4232.


                                                                                 - Kate Segel

June 14, 2016

On Thursday, the Connector Board met to discuss Health Connector open enrollment operational readiness, outreach and messaging efforts, and the Student Health Insurance Program. Materials from the meeting are posted here

Executive Director’s Report
First, Louis Gutierrez, the Executive Director of the Health Connector, shared some updates:

  • Massachusetts received approval from CMS to maintain small-group rating practices.
  • The Health Connector plans to transition the market-wide risk adjustment program they had been administering to CMS beginning in 2018 (for plan year 2017).
  • The Health Connector is entering into a contract with Dell (which will be acquired by Japanese firm NTT) to modernize their customer relations management system.
  • The Health Connector is looking at metrics to evaluate the impact of their upcoming outreach efforts to reach the uninsured.
  • Health Connector enrollment as of June 1, 2016:
    • Total non-group medical: 223,778
    • Unsubsidized and APTC: 52,503
    • ConnectorCare: 171,275
    • Non-group dental: 59,471
    • Small group medical : 5,922
    • Small group dental: 831

2017 Open Enrollment Preparations 
Based on Department of Revenue tax-filing data,  the remaining uninsured people in the state (approximately 3.6%, or 240,000 residents)  are almost evenly divided between chronically uninsured and temporarily uninsured; evidence shows that Hispanics are the most likely population to remain chronically uninsured, both in Massachusetts and nationally. Connector Board and staff members spent a good portion of the meeting discussing how to best target the remaining uninsured.

In preparation for the next open enrollment period, which begins in November, the Connector Board approved a contract with Dell, who provides customer service for the Connector, to re-launch temporary walk-in centers throughout the Commonwealth for the 2017 open enrollment period. These walk-in centers complement the permanent walk-in centers in place in Boston, Worcester, and Springfield. During the 2016 open enrollment period, the “pop-up” walk-in centers – co-located with community health centers – served 15,000 consumers, helping with issues that only customer service can address, such as billing and payment.

The Connector Board also approved outreach and marketing contracts with Weber Shandwick and Archipelago Strategies Group, to conduct outreach and media campaigns to better reach the remaining uninsured.  Weber Shandwick will conduct general outreach and marketing, while Archipelago will focus on ethnic outreach and media. 

Student Health Insurance Program
Lastly, the Board discussed the Student Health Insurance program (SHIP). Since 1989, all students in the Commonwealth have been required to have health insurance, and each school is required to offer a SHIP. Students are able to waive the coverage if they have comparable coverage elsewhere, such as a parents’ employer plan or, since the passage of the ACA, MassHealth. Since the passage of the ACA, fewer students have been enrolling in SHIPs, in large part likely due to newly-gained access to MassHealth. In an effort to keep premiums in SHIP plans reasonable, and retain access to MassHealth, the Commonwealth has begun a pilot program to enroll MassHealth students into Premium Assistance. Like other MassHealth Premium Assistance programs, students enroll in their private plan (in the case, the school’s SHIP), and MassHealth helps them pay for their premiums and cost-sharing. MassHealth plans to roll this out to all full-time college students receiving MassHealth coverage in coming months and years.

The next Connector Board meeting is scheduled for Thursday, July 14th from 2-4pm at 1 Ashburton Place, 21st floor, Boston. 

- Sara O’Brien

June 13, 2016

Pie chart of state budgetThe House-Senate conference committee on the Fiscal Year 2017 state budget held its first meeting last week to negotiate a final budget based on the House and Senate budgets passed in each branch. The new state fiscal year will begin on July 1.

HCFA is pleased that each budget proposal includes a number of provisions that fund MassHealth and other key health programs, and advance consumer health interests. However, there are important differences between the two versions, and HCFA distributed the following statement to the legislative leadership indicating our priorities for the budget process:

The challenges facing our Commonwealth are significant. Recent revenue declines mean difficult funding decisions. The budget proposals put forward by both the House and the Senate reflect the commitment by the Legislature to not retreat from effective, innovative government policies that promote the health of all Massachusetts’ residents, and we should collectively be proud of the many provisions that will benefit health care consumers.   

As you work to develop the final FY 2017 budget, HCFA urges you to prioritize these goals:

  • Protect the Health Safety Net Program;
  • Expand access to dental care through Dental Hygiene Practitioners;
  • Provide unbiased information about the cost and efficacy of prescription drugs;
  • Streamline public benefit program applications to improve health and decrease health costs;
  • Plan care improvement for infants exposed to substances;
  • Complete the study on drug copay coupons before changing policy;
  • Examine the impact of limited MassHealth dental coverage; and
  • Adequately fund the statewide dental program for people with disabilities.

Protect the Health Safety Net Program

The Health Safety Net (HSN) lives up to it name. It is our last resort program to meet critical health needs of low income residents of the Commonwealth without any other source of assistance. Senate Section 77A (redrafted amendment 369) delays proposed eligibility reductions through April 1, 2017, giving the Legislature, Administration, and stakeholders the opportunity to better understand the impact of the cuts and develop appropriate policy responses. HCFA opposes the cuts proposed by the Executive Office of Health and Human Services (EOHHS), and urges reconsideration of their implementation. The eligibility cuts would shift costs to providers and leave many low-income people with substantial medical debt.

The HSN is primarily funded by an assessment on hospitals and payers, while the state customarily contributes $30 million of federal reimbursement it receives from revenue generated by the assessment. The Administration’s FY2017 budget did not include any state funds for the HSN. Both the House and Senate provide $15 million in funding, though the House budget includes “up to” language that could potentially result in less funding being transferred to the Health Safety Net (House Section 42). We urge the conference committee to support the Senate budget approach that specifies a firm $15 million for the program (Senate Section 72).

We urge the Conference Committee to include a provision delaying implementation of eligibility cuts in the Health Safety Net program until April 2017 and specify $15 million in state funding for the HSN.

Expand Access to Dental Care through Dental Hygiene Practitioners

One in ten Massachusetts residents does not have access to a regular dental provider. Only 35% of dental providers accept MassHealth, making it even harder for seniors, children, and other vulnerable populations to access basic dental care. Dental care must be more easily accessible.

A dental hygiene practitioner is similar to a nurse practitioner and would improve access to dental care. Dental hygiene practitioners could work in settings such as schools and nursing homes to make care accessible. They may also work directly with dentists, allowing practices greater financial flexibility to see more MassHealth patients. Sections 35A-35D and Section 77A of the Senate budget (redrafted amendment 479) authorize dental hygiene practitioners in Massachusetts.

We urge the Conference Committee to include provisions authorizing Dental Hygiene Practitioners to be licensed as a new midlevel dental provider.

Provide Unbiased Information about the Cost and Efficacy of Prescription Drugs

Health care providers are confronted with an overwhelming amount of new clinical research, making it difficult to stay current about which treatments are most effective and have the best patient outcomes. At the same time, the pharmaceutical industry spends billions on marketing directly to doctors to promote their products. This influence results in higher costs for patients and the Commonwealth as pharmaceutical representatives typically promote their newest, most expensive brand-name drugs, regardless of whether or not they offer improved outcomes.

June 7, 2016

Boston Globe editorial: Proceed with caution on drug copay discounts

At first glance, discounts on prescription drug copays via “coupons” seem like an enticing offer. Many patients struggle to afford their copays. Until 2012, Massachusetts banned drug coupons for fear that they would ultimately result in higher costs for the whole healthcare system. When the ban was lifted, the plan was to allow drug coupons temporarily, until 2015, and to conduct a study on the cost ramifications. 

What happened next is typical: the study never happened, and the sunset date was extended to 2017. And now, a rider was added in the House version of the 2017 state budget that would allow coupons indefinitely. The Senate version does not have the provision.

The issue is now before the House-Senate conference committee reconciling the budget versions. HCFA strongly opposes the provision removing the sunset clause, and urges the legislature to press the state to conduct the study in order to make an informed decision.

The Boston Globe’s lead editorial on Saturday supported our approach. The Globe wrote:

There are good reasons to proceed cautiously on drug discounts, starting with pharmaceutical companies’ motives for offering them. … [K]eeping the status quo in place allows patients to continue reaping short-term savings on prescription drugs while the long-term ramifications are sorted out.

The editorial cites a statement from the head of the state’s Biotechnology Council, who supports removing the sunset clause immediately, and skipping the study. Why are they so opposed to doing a study first? Perhaps, it’s because existing evidence indicates that drug coupons may not be a cost-effective as they seem.

Drug coupons are offered as a marketing tactic to increase sales of high-price drugs when there is a less expensive alternative. The cost of paying for these more expensive, brand name drugs eventually gets passed on to us, though higher premiums. And then insurers respond by barring certain drugs from coverage. For example, according to a recent STAT article, Express Scripts excluded 80 medications from coverage in 2016 due to cost, 67% more than in 2014. And guess what - 90% of these excluded medications had drug coupons available for them. All the while, drug coupon offers have been on the rise continuously – from 86 in 2009 to almost 750 today.

Like most sales, drug coupons are often temporary. When the sale ends, consumers are then hit with copays full force. By this time, patients are often attached to the medication, unaware of cheaper, equally effective options. Drug companies also extract personal information from consumers in exchange for the coupon, giving them free rein to bombard them with further advertising. The end result is more and more high-cost drug consumption, fueling significant cost increases for payers – costs which will then be passed on to all patients.

Due to these concerns, it is critical that the Center for Health and Information Analysis do the study it was charged with conducting in 2012. If drug coupons are really having no negative impact on costs and health care system in general, the pharmaceutical industry should have nothing to fear. Clearly, companies want to sell as much of their most expensive products as possible. An individual patient may very well receive a good deal from an individual coupon. But the sword cuts both ways. The larger structural implications of drug coupon schemes must be assessed.

                                                                                                                             -- Mike DiBello

June 5, 2016

The debate over authorizing “dental hygiene practitioners,” to improve access to good oral health, just heated up a lot more this week.

Background: Dental Hygiene Practitioners (DHPs) are dental hygienists who – after completing additional training – are able to deliver basic but critically necessary care to underserved populations in the state. DHPs work under the supervision of a dentist, and can bring care directly to people in schools, nursing homes, and other community settings. Access to oral health care is a particularly difficult for older adults, for people with disabilities, for children with MassHealth coverage, and for rural communities. Licensing this new oral health care clinician, as is done successfully in several other states, would expand access to essential health care for these underserved people.

With our strong support, the state Senate unanimously voted to include a provision creating DHPs in its version of the budget. But there’s no corresponding provision in the House budget, so the issue is up to the joint House-Senate budget conference committee which begins meeting this week.

However, the Mass Dental Society has come out strongly against the proposal, spending many tens of thousands of dollars to convince the public to oppose the provision. 

Meanwhile, objective experts are weighing in strongly in favor of the proposal.

Two weeks ago, Dr. Don Berwick, former president of the Institute for Health Care Improvement, an evidence-based center devoted to quality care, and a former national administrator of Medicare and Medicaid, wrote a detailed review in the Globe of studies supporting DHPs. He cited over 1,100 studies which found that DHP care is certainly comparable, and often superior, to care from a dentist. Berwick, who also sits on the state's Health Policy Commission, concluded,

“Proper dental care is as much a human right and as smart an investment as is proper medical care. By passing the Dental Health Practitioner legislation, Massachusetts now has a chance to add access to dental health to its list of proud commitments.”

This was amplified at a meeting of the state’s Health Policy Commission on Wednesday. The HPC revisited key findings on emergency department visits for preventable oral health conditions, noting that almost half of all preventable ED visits for oral health were paid for by MassHealth, while just 35% of all licensed dentists in Massachusetts accept MassHealth. In light of these glaring numbers, the HPC pointed to licensing DHPs as proven solution:

Health Policy Commission Support for Dental Hygiene Practitioners


Commissioners enthusiastically supported the proposal. Commissioner David Cutler stated that he was “convinced” of the model and Commissioner Berwick reiterated that establishing mid-level dental providers is a “slam dunk” policy that expands access, potentially decreases costs, and also serves as an opportunity for economic growth by providing a new health care career path. Although Commissioner Carole Allen admitted she was initially cautious as some providers have indicated concerns about establishing a “2-tiered system of care,” after further studying the significant amount of evidence affirming the quality of care delivered by mid-levels and their potential for expanding dental access, she is now a firm supporter of the model, she said.

Health Care For All rejects the calls for more study and delay.  The evidence is overwhelming that DHPs would provide high-quality dental care to people who need it the most. We urge people to contact their state representative and ask them to contact the House members of the budget conference in support of this “slam-dunk” policy.

                                                                      -- Kelly Vitzthum


May 26, 2016

CMHCDarcy is a mother of two children with medical and mental health challenges, the Director of Family Connections at The Walker School, and advocate for “wraparound” services. Wraparound services are an intensive and holistic set of services that help individuals with complex needs stay in their communities. 

Below is an interview with Darcy on why wraparound services are so important for children’s mental health.

What drove you to become an advocate for children’s mental health services?

  • My oldest daughter started to struggle with mental health issues when she was around 12 years old and we began the long journey through hospitalizations and residential placements.  There is a lot of stigma associated with mental health – and I found that the more I fought against the stigma by talking to friends and family members about it, the more I realized that everyone is connected to someone in their family or a friend that also struggles with mental health challenges.  I wanted to make sure other families didn’t feel like they were going through this alone, so I began to help other families by telling my story and giving them information about resources and how to access services that would help their children.
  • Most recently my 13 year old daughter was hospitalized and has been struggling with mental health issues.  Both my girls have private insurance and MassHealth as a secondary insurance.  And while we do have access to Children’s Behavioral Health Initiative (CBHI) services, it is still a struggle to be able to get the appropriate services they need.  We had to change our private insurance plan to be able to access certain services because the agency/hospital took MassHealth but not our private insurance.  Seeing families not able to access great services because their private insurance is a barrier - it's just crazy! Families who pay for commercial insurance should not need MassHealth in order to get the services their child needs. The Commonwealth is currently paying for services that could, and should be covered by children’s commercial insurance plans and these services ultimately will be more cost effective than out-of-home placements.

What types of services were your children unable to access on commercial insurance?

  • We were unable to get in-home therapy, therapeutic mentoring, and effective care coordination for the girls. I have run into a lot of barriers for my oldest daughter because of private insurance issues.  For example, we have been looking for an outpatient clinician that does outreach (in the home) sessions because my daughter has trouble accessing traditional outpatient therapy.  
  • The issue is that the agencies that do outreach therapy do not have Masters level clinicians, because we have a commercial insurance, the clinician has to meet the requirements of the private insurer and then MassHealth.  
  • We are also running into an issue where we would like to get my 20 year old daughter In Home Therapy through CBHI – but because she lives on her own, the CBHI providers are saying she does not qualify because she does not live with her “family”.  She is a household of 1, and is her own family. CBHI is designed for "family" therapy, thus living on your own means you no longer quality.  Because we have advocated and attained the goal all parents want for their children (living on their own) – she is being penalized and cannot access a CBHI service. 

How has access to MassHealth’s wrap around services improved your daughter’s care?

  • My 13 year old daughter is currently accessing in home therapy through CBHI.  She does not do well in a traditional outpatient therapy model – so having clinicians come to our home is making it so she can get the therapy she needs.

What have been the financial and emotional impacts of navigating the insurance markets on you and your family as well as your daughters?

  • Private insurance can get expensive when you add in the premiums as well as the co-pays.  The real problem happens when a provider does not take your insurance, and the family then has to pay out of pocket for every visit. 

How would you advocate to begin to fix the issues? 

  • To begin with, CBHI services should be available to all Massachusetts families through MassHealth and private insurance.  I would also want to take a look at CBHI regulations and advocate for some changes for transitional-aged youth.

As a mental health professional: can you explain why these wraparound/community based services are so critical for young people? 

  • There are NO services out there that compare.  Some providers do offer limited in-home, community based services – but these families typically have to pay out of pocket.  How can we help children and families when there is no parity?  If you do not know how to access MassHealth, or your income is such that paying the premium for MassHealth is too high – then your child and family are missing out on valuable time in their lives to gain coping skills to overcome challenges.

What advice would you give to other families on commercial insurance struggling to access to mental and behavioral health services for their children?

May 25, 2016

Oral Health is overall healthIn a stunning 39-0 unanimous roll call vote, the State Senate today voted to add Senate Majority Leader Harriette Chandler's amendment authorizing a new type of dental professional to serve our most vulnerable populations.

The amendment would create a new midlevel dental provider, the Dental Hygiene Practitioner (DHP). DHPs are dental hygienists who – after completing additional training – are able to deliver basic but critically necessary care to underserved populations in the state. DHPs will work under the general supervision of a dentist, using telehealth technology to share X-rays and patient records with the dentist and consult on complicated cases.This will allow DHPs to bring care directly to people in schools, nursing homes, and other community settings. DHPs will deliver critical dental services like filling cavities, placing temporary crowns, and extracting loose teeth.

In 2014, just 35% of dentists treated a MassHealth patient and only 26% billed at least $10,000 to the program. Furthermore, Massachusetts has 62 federally designated dentist shortage areas including 69 cities/towns with no dentist at all; an estimated 244,000 people in those areas are not able to have their dental needs met.Despite recent progress on health care, many residents in Massachusetts struggle to access dental care, and a person’s ability to receive adequate dental care is largely determined by age, race, income, insurance status, and geography. If you are a senior living in the Berkshires or a child on MassHealth in South Boston, the reality is the same: it may be hard to get adequate dental care.

HCFA's Executive Director, Amy Whitcomb Slemmer, praised passage of the provision:

"As we envision a more patient-centered health care system that integrates oral health, we must embrace alternative strategies that make it easier and more affordable for children and families to access the dental care they need. Passage of this provision is a crucial step forward as it will expand the dental team and give dentists the ability to bring care directly to patients in the community."

Similarly, yesterday the Boston Globe published an op-ed by Dr. Donald Berwick that summed up all the reasons to support creation of DHPs:

Proper dental care is as much a human right and as smart an investment as is proper medical care. By passing the Dental Health Practitioner legislation, Massachusetts now has a chance to add access to dental health to its list of proud commitments.  

This was brought out in detail by Senator Chandler in today's Senate debate:

All the problems one gets in oral health can end up in an emergency room and can be life threatening, deaths can be caused as a result. I know we don't always think of it that way.... This will bring good oral health to literally thousands of people who do not. There are so many people in nursing homes who took care of their teeth for years and now there are no dentists who will go there. These people  [DHPs] will go to nursing homes, they will go into school and other places dentists just don't go into. The fact is that we have studies that show that it costs between 4 and 9 times more to have your treatment in an emergency room than it does with a hygienist or dentist.

The provision's fate will now be up to a House-Senate conference committee, which will meet during June to hammer out a final budget. There is no equivalent provision in the House version of the budget. The strong vote today sends an important message to the conference that this is a top Senate priority.

                     -- Brian Rosman

May 25, 2016

Good news!  Last night (Tuesday May 24), the State Senate approved an amendment to delay planned eligibility cuts in the Health Safety Net program. The amendment was a top priority of HCFA and the ACT!! Coalition (see this ACT!! fact sheet for more information).

The Health Safety Net (HSN) reimburses hospitals and community health centers for providing care to low-income uninsured and underinsured Massachusetts residents. The Baker administartion recently approved regulations that would cut eligibility for the program by :

  • imposing substantial deductibles on individuals earning between 150-200% of the federal poverty level ($17,000 - 23,000 per year for an individual);
  • reducing the income for overall program eligibility from 400% FPL to 300% FPL; and
  • shortening the time period for which HSN will pay for services incurred.

The amendment passed in the Senate last night was sponsored by Senator Jason Lewis of Winchester, who spoke in favor of his proposal. The amendment would postpone the planned cuts until April 1 of next year. The amendment did not include the additional $15 million in state funds for the program also supported by HCFA and ACT!!.

The provision still needs to be approved by the House-Senate budget conference committee, and be approved by the Governor, in order to become law. The House did not include any language on the HSN cuts in its version of the state budget.

Because the regulations are scheduled to take effect on June 1, and the budget will not take effect until July 1, we will be urging the state to hold off on implementing the cuts until after the conference committee concludes.

We thanks everyone who contacted their Senator on this, and will continue to work to support the HSN program.

                                  --- Brian Rosman

May 23, 2016

Massachusetts Senate chamberThe Massachusetts State Senate will vote on its version of the state budget starting on Tuesday, May 24. Massachusetts uses a fiscal year that starts on July 1, so this budget starts in just a few weeks. The budget allocates funds for state programs, such as MassHealth and the Department of Public Health, and sets state policies in many areas. You can read a detailed summary of the budget from the Mass Budget and Policy Center here.

Senators have proposed over 1100 amendments to the budget which will be considred over the course of the debate, which should last 3 or more days. A number of these would strengthen the state’s health care system, and are supported by HCFA. A list of these amendment is below. Please call or email your State Senator today, in support of these amendments (go to WhereDoIVoteMA.com to look up your Senator). Your voice makes a real difference. We heard from a state legislator last week that just a few calls into his office can change his priorities.

Here's the list of HCFA priority amendments:


Protect Health Safety Net Eligibility & Funding

The Health Safety Net (HSN) reimburses hospitals and community health centers for providing care to low-income uninsured and underinsured Massachusetts residents. Recent eligibility cuts and funding reductions impose barriers to care for individuals without access to affordable health coverage. You can download a fact sheet on the program cuts and the amendment for more information.

  • Support Sen. Lewis’s amendment (#369; EHS category) to protect Health Safety Net eligibility and continue investing $30 million in the program, ensuring continued access to care for low-income uninsured and underinsured residents.

Ensure Access to Oral Health Services for People with Disabilities

Individuals living with disabilities have particular oral health needs, including adaptive facilities and equipment, as well as providers with specialized training. See this fact sheet on the issue.

  • Support Sen. Lovely’s amendment (#474; EHS category) to allocate an additional $500,000 for the dental program for individuals with intellectual and developmental disabilities (line item 4512-0500). 

Expand Access to Dental Care

One in ten Massachusetts residents does not have access to a regular dental provider. Further, only 35% of dental providers accept MassHealth, making it even harder for vulnerable populations to access basic dental care. Dental care must be more easily accessible. More information is available on this fact sheet.

  • Support Sen. Chandler’s amendment (#479; EHS category) to establish a new mid-level dental provider, a Dental Hygiene Practitioner, which would expand access to basic dental services for the most underserved parts of the state.

Ensure Homeless Families’ Access to Nutritious Meals

Families who live in hotels and motels often don’t have a way to keep food fresh, and can’t cook or store nutritious meals. Families without access to nutritious meals are affected in many ways, like children being unable to focus in classes, and parents going hungry to feed their children. This also leads to higher health care costs. More details are on this fact sheet.

  • Support Sen. Montigny’s amendment (#14; Other Category) to create a special commission to study the need for and methods to provide nutritious meals to families in temporary housing in hotels and motels.

Protect Substance Exposed Newborns and those with Neonatal Abstinence Syndrome

Preventing long-term side effects in newborns who have been exposed to harmful chemicals is an important aspect of children’s overall health and wellbeing. An interagency taskforce can gather information, and establish plans to improve care for newborns who have been exposed to harmful substances which compromise their health. See this fact sheet for more information

  • Support Sen. Flanagan’s amendment (#500; EHS category) to establish an interagency taskforce focused on the health of vulnerable newborns.

Invest in Oral Health

Charged with preventing dental disease and improving oral health in all Massachusetts communities, the Office of Oral Health at the Department of Public Health (DPH) is an essential component of our state’s public health infrastructure. More information is available on this fact sheet.

May 17, 2016

The Massachusetts State Senate released its proposed state budget on May 17. The budget's theme is "Investing for a resilient Commonwealth," and there are a number of bold, creative initiatives, particularly around children's programs,  In response, HCFA released the statement below. The budget debate begins in the Senate on Tuesday, May 24. HCFA will be working with Senators on a number of amendments to strengthen health care for Massachusetts.


BOSTON - Statement from Health Care For All's Executive Director Amy Whitcomb Slemmer Regarding the Senate FY2017 Budget Proposal:
Health Care For All appreciates the work of Senate Ways and Means Chair Karen Spilka and Senate President Stan Rosenberg on proposing a thoughtful budget that focuses on directing funding to key programs for our communities.
We are pleased that the Senate's proposed budget includes a directive for MassHealth to work with other human service agencies to design one common application for all the benefits people may qualify for, including health care, food assistance, housing and child care. Streamlining access to multiple social services has the potential to improve the population's overall health and lower the cost of health care for the state.
We also applaud the Senate for funding the state's program that educates doctors on cost-effective use of prescription drugs. The so-called "academic detailing" program counters the aggressive marketing efforts by the drug industry to get doctors to recommend the most expensive, high-profit drugs, even when more cost-effective alternatives work just as well.
HCFA appreciates the inclusion of funding for the ForsythKids program, which offers school-based preventive dental care. This program works with schools and community partners to make it easy for children and families to access high quality dental care, which is critically important to their overall health and well-being.
The Senate budget also allocates full funding for the Early Intervention (EI) program, which provides family-centered services to help children who qualify develop the skills they need to grow into happy and healthy community members. The long-term payoff of the EI program for better health and economic sufficiency has been shown again and again, and we're pleased to see the Senate invest in this initiative.
However, we were disappointed to learn that the fiscal plan does not reverse cuts announced by the Baker Administration to eligibility for the Health Safety Net program. This program provides critical access to care at hospitals and community health centers for people ineligible for any other health care program. We urge the Senate to protect this long-standing linchpin of health care in Massachusetts for the most vulnerable members of our community.
We also are displeased by the gap between the appropriations level and the need for funding for the Tufts Dental Facilities. This program provides outstanding oral health care at seven locations throughout the state to disabled people who rely on the special expertise and facilities of the program. We hope the Senate can increase the allocation to the program so it can continue to serve all who need its care.
We appreciate the effort and work that has gone into this fiscal proposal and we look forward to work with the members of the senate towards achieving a balanced budget that takes steps to improve the health and well-being of all residents of the Commonwealth.