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.