The 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.