October 2015

October 28, 2015

Advocates for health and child well-being gathered at the Massachusetts State House on Tuesday, October 20th, to support H.429/S.94: An Act Relative to Ensuring the Wellbeing of All Children in the Commonwealth, sponsored by Senator Montigny and Representative Livingstone. The bill aims to integrate assistance for children and families who need improved access to food, housing, and medical care. Support for the legislation is led by the Healthy Food, Healthy Homes, Healthy Children (HHH) Coalition, a group of service providers, researchers, and advocacy groups who take a holistic approach to childhood wellbeing, with the belief that housing, health care, and hunger are all inextricably linked.  The legislation aims to promote childhood wellbeing by improving access to – and integrating – food, shelter, and medical care.

Prior to the hearing, HCFA hosted a press event to highlight the importance of the bill, and introduce the legislation to the public. At the press event, supporters of the bill spoke about how in order to address health problems among children, it is necessary to tackle poverty as the root cause. The event featured several speakers, including HCFA Executive Director Amy Whitcomb Slemmer,  Representative Jay Livingstone, Dr. Megan Sandel from Boston Medical Center and Children’s HealthWatch, and Diane Sullivan, the Policy Director of Homes for Families, who spoke about the issue from personal experience. Ms. Sullivan had previously been a homeless mother, and spoke about how, without access to proper resources and support, families cannot be expected to lift themselves out of poverty. Representative Livingstone, the lead sponsor of the bill in the House, spoke about how although so many children have health coverage, that does them little good if they lack the basic necessities to lead healthy lives. By viewing access to health care, housing, and food as integrated issues, the bill aims to provide children the necessary foundation to lead healthy lives.

Following the press event, a number of experts testified in support of the bill at the hearing before the Joint Committee on Children, Families and Persons with Disabilities.  Testimony covered the various sections of the bill, including:

  • A ‘common application’ for core Massachusetts safety net benefits, including MassHealth and SNAP benefits
  • Establishing a working group to assess methods for providing meals to homeless families temporarily housed in hotels and motels
  • Changing administrative processes to reduce ‘churn’ – the closing and reopening of benefits eligibility due to recipients’ income fluctuation

Particularly compelling testimony came from Dr. Lois Lee, a physician in the Division of Emergency Medicine at Boston Children’s Hospital, and an Assistant Professor of Pediatrics at Harvard Medical School. Dr. Lee spoke about family eligibility for emergency shelter. Currently, families must spend one night in a setting not meant for human habitation before they can be eligible for placement in emergency shelter.  Dr. Lee spoke about how this rule puts unnecessary stress on both the families that must satisfy this requirement, and the hospitals that end up assisting them. These families seeking shelter are almost always single mothers with children under the age of 5, and the hospital is obligated to provide them with a room. When space is scarce, the obligation to provide these families with a room often means that there is not a room for another patient that may be in need. Dr. Lee also noted that while in these rooms, families are confined and limited in their ability to move around because a hospital is not suited for the needs of sheltering children and their families. For many, it’s not just a question of short-term or situational health: “Homelessness affects not just physical health, but can cause long-term developmental issues”, she said, emphasizing the importance of this comprehensive bill.

Led by Health Care For All, advocates across the spectrum of health and children’s wellbeing will continue to work to move this legislation forward so families and children have the resources to lead healthy lives. If you would like more information about the HHH coalition or the legislation please visit the coalition website.

                           - Ben Koller

October 15, 2015

At Tuesday’s Joint Committee on Health Care Financing public hearing, legislators heard testimony from advocates, consumers and health providers on a number of important bills, including three of HCFA’s priority bills:

  • H. 984/S. 606, An Act to keep people healthy by removing barriers to cost-effective care;
  • H. 964/S. 595, An Act to preserve affordable health coverage for Massachusetts residents; and
  • H. 1025, An Act relative to preventing unnecessary medical debt.

Senator Lewis and Representative Farley-Bouvier testified first in support of H.984/S. 606, An Act to keep people healthy by removing barriers to cost-effective care, also known as the No Co-pay Bill. The bill, which is one of HCFA’s main legislative priorities, would eliminate co-pays for certain high-value, cost-effective drugs and treatments for people with chronic conditions. As Senator Lewis explained, cost is a major barrier for many patients. While price tiering is a useful method to prevent overutilization, it harms those with chronic conditions who have no choice but to take multiple medications to stay healthy. In the long run, Representative Farley-Bouvier stated, this approach, based on the premise of value-based insurance design, will provide a large health benefit for consumers at a comparatively low cost.

Next to testify in support of the No Copay bill was Ruthie Liberman from the Crittenton Women’s Union (CWU). As Ms. Liberman noted, CWU, whose mission is to promote the economic independence of women through housing and employment programs, doesn’t typically testify on health care bills. However, a study by CWU based on surveys and interviews found that medical debt was a critical factor keeping many families in the cycle of poverty. Specifically, the prohibitive cost of copays and deductibles was a source of debt for over one third of survey respondents. Ms. Liberman emphasized the importance of affordable medical care in eradicating poverty for Massachusetts residents.

Finally, we heard from a panel of HCFA grassroots activists introduced by HCFA senior health policy manager Alyssa Vangeli. Their personal stories illustrated the devastating effect high co-pays can have on patients and made a strong case for eliminating cost-sharing for certain high-value drugs and treatments. Mercy Nunez, for example, has a number of different conditions, including high cholesterol, congestive heart failure, and type I diabetes. She has to take over 14 medications, and her poor health prevents her from holding a job. Struggling with the high cost of her copays, Mercy was unable to afford all of her medications; as a result, she had a medical emergency that landed her in the ER, where she was admitted to the hospital for two months. The cost of her entirely preventable hospital admission was far higher than if she had been regularly taking her medications.

Maria Melendez is another patient who, burdened by exorbitant copays, tried to take her health into her own hands because of high out-of-pocket costs. Maria has type I diabetes and has to pay over $200 each month for daily treatments to manage her disease and stay healthy. A few months ago, feeling pinched economically, she began undereating in order to reduce the amount of insulin she needed. After an appointment where her doctor detailed the devastating effects her behavior could have on her health, she began adhering to her medication plan. The added cost, however, forced her to move back in with her mother. Valerie Spain also shared her story of struggling to pay for diabetes supplies due to high copays.

In addition to oral testimony, HCFA submitted written testimony, a policy brief, and a sign-on letter, with support from a number of organizations including Atrius Health, Boston Children’s Hospital, Health Law Advocates, Joslin Diabetes Center, National Alliance on Mental Illness MA, AIDS Action Committee, Crittenton Women’s Union, 1199 SEIU and American Heart/American Stroke Association.