2017-2018 Legislative Priorities
Health Care Affordability
- Reduce Out-Of-Pocket Health Care Costs: HD 515/SD 229 (Rep. Farley-Bouvier & Sen. Lewis):
Increasing co-pays and deductibles have become an obstacle to good health care in MA. As out-of-pocket costs rise, patients may be less likely to access care or follow prescribed treatments and medications, especially patients with low incomes or chronic conditions. An Act to Keep People Healthy by Removing Barriers to Cost-Effective Care will eliminate cost-sharing for high-value services and drugs such as insulin, asthma inhalers, and hypertension medications, thereby improving adherence and patient outcomes.
- Preserving Affordable Health Coverage: HD 2023/SD 1583 (Rep. Balser & Sen. Jehlen):
Access to affordable health coverage is the cornerstone of successful health reform policy. An Act to Restore Affordable Health Connector Coverage ensures that premiums and cost-sharing remain affordable for individuals who receive subsidies to purchase health insurance through the Health Connector. This is especially important in light of recent ConnectorCare premium increases and impending federal changes to the Affordable Care Act.
Health Care Confidentiality
- Enhance Confidentiality in Medical Care: HD 3059/SD 1174 (Rep. Hogan & Sen. Spilka):
Health insurers routinely send out an explanation of benefits form (EOB) to the primary policyholder detailing medical services received each time an enrollee on their plan accesses care. In cases where a spouse or dependent utilizes care that they wish to remain confidential, an EOB addressed to the policyholder violates the patient’s privacy. An Act to Protect Access to Confidential Healthcare would ensure that when multiple people are on the same insurance plan, confidential health care information is not shared with anyone other than the patient.
Children’s Health Access
- Improve the Children’s Medical Security Program: HD 2594/SD 467 (Rep. Malia & Sen. DiDomenico):
The Children’s Medical Security Program (CMSP) provides basic coverage to children who are otherwise ineligible for other public health insurance programs. With strict limits on covered services and coverage amounts, CMSP coverage may not provide sufficient benefits to keep a young person healthy. An Act Improving the Children’s Medical Security Plan and Simplifying the Administration Process gives EOHHS the flexibility to address the health needs of children by eliminating service caps, while staying within the program’s annual appropriation.\
- Ensure Continued Coverage for Children: HD 769/SD 382 (Rep. Cronin & Sen. L’Italien):
The Children’s Health Insurance Program (CHIP) provides comprehensive, affordable health coverage to uninsured children and pregnant women who have lower incomes, but make too much to qualify for Medicaid. Federal funding for CHIP runs out after September 30, 2017. Unless Congress re-funds CHIP or Massachusetts acts affirmatively to continue coverage for young people covered by the program, about 160,000 children and youth enrolled in CHIP and thousands of pregnant women will lose their health insurance. Act to Ensure Continued Health Insurance Coverage for Children ensures that CHIP enrollees maintain coverage regardless of federal action on the program.
- Increase Access to Children’s Mental Health Services: HD 2011/SD 587 (Rep. Balser & Sen. Lewis):
An Act to Increase Access to Children’s Mental Health Services in the Community requires coverage for community and home-based behavioral health care services (“wraparound care”) for children and adolescents with mental health disorders who are covered by commercial insurance. Currently, these services are only available to children with MassHealth and their families, through the Children’s Behavioral Health Initiative (CBHI). Families with commercial insurance either go without these services, or use “secondary MassHealth” to obtain the services.
Dental Care Access
- Expand Dental Access in Massachusetts HD 2156/SD 1005 (Rep. Pignatelli & Sen. Chandler):
The most vulnerable populations in Massachusetts often go without oral health care due to lack of easy access to a dentist. An Act Authorizing Dental Therapists to Expand Access to Oral Healthauthorizes a new type of midlevel dental professional, the dental hygiene practitioner (DHP). DHPs present a critical opportunity for Massachusetts to close gaps in dental access for seniors, low-income families, children, and people with special needs.
- Restore MassHealth Dental Benefits: HD 1592 (Rep. Scibak):
An Act Relative to the Restoration of MassHealth Adult Dental Benefits will restore full MassHealth dental benefits to more than 800,000 individuals, including 120,000 seniors and 180,000 people living with disabilities. Left untreated, dental disease can lead to systemic infection, hospitalization, and the worsening of other medical conditions. Oral health is an integral part of overall health and should be included in health coverage.
Health Insurer Provider Directories
- Ensure Accuracy of Health Plan Provider Directories: HD 3106/SD 1405 (Rep. Barber & Sen. Flanagan):
Families and individuals seeking care in Massachusetts are often unable to find accurate, reliable information about the provider network available through their health plan. Insurers do not regularly update provider directories, so patients or their families who are seeking care cannot find a provider when they need one. An Act to Increase Consumer Transparency about Insurance Provider Networks requires insurers to meet reporting and transparency standards and reduces barriers to accessing out-of-network care when the plan lacks appropriate in-network providers.
- Increase Prescription Drug Cost Transparency: HD 992/SD 923 (Rep. Tosado & Sen. Montigny):
Prescription drug prices continue to rise, increasing the cost of health insurance for individuals, families, employers and the state. An Act to Promote Transparency and Cost Control of Pharmaceutical Drug Prices will shed light on the true costs of drug development. The House and Senate bills, while slightly different, both will provide open, public transparency around how much drugs actually cost to manufacture, how much people in other countries pay, the true price charged for the drug in Massachusetts, and the research and advertising costs for the most expensive drugs.
- Ensure Provider Access to Unbiased Information about Prescription Drugs: SD 228 (Sen. Lewis):
An Act to Reduce Healthcare Costs by Promoting Non-Biased Prescriber Education will address the problem of rising prescription drug costs by creating an “academic detailing” program to respond to pharmaceutical industry efforts to market only the newest and most expensive prescription drugs to prescribers. The academic detailing program would consist of a network of physicians, healthcare providers, insurers, and other stakeholders tasked with delivering unbiased, evidence-based information to prescribers regarding prescription drugs and other therapeutically equivalent alternatives for potential use by their patients.
For more information, please contact Suzanne Curry at Health Care For All:
firstname.lastname@example.org / (617) 275-2977