February 2016

February 29, 2016

Crowds gather at the State House for Elder Leap Day 2-29-16

Today, Health Care For All was delighted to join hundreds of seniors, advocates, and caregivers at the Grand Staircase in the State House to advocate for services that keep seniors healthy and living at home. Mass Home Care organized and AARP Massachusetts State Director Mike Festa emceed the event. Over a dozen senior and disability organizations sponsored the event.

According to Mass Home Care, the elderly population in Massachusetts will increase 40% by the year 2035, with nearly 40% of elder needing long term services for more than two years in their lifetime. Today’s lobby day was an amazing showing of energy around policies that will ensure seniors of today and tomorrow have the resources and community supports they need, including home care, adequate housing and transportation.

Issues highlighted include:

  • Eligibility and funding for home care services
  • Proposed passive enrollment into Senior Care Options
  • Supporting caregivers
  • Expanding MassHealth eligibility for seniors
  • Fair pay for home care workers and personal care attendants
  • Opposing EOHHS authority to restructure MassHealth benefits
  • Protecting the Community Choices program
  • MassHealth estate recovery

Mass Home Care has a good rundown of some of the issues raised. HCFA supports these efforts to help older Massachusetts residents remain independent and living with dignity in their homes and communities.

     - Suzanne Curry

February 28, 2016

S. 2138 - An Act to protect Confidential Healthcare

Last week, the Massachusetts Senate advanced S. 2138, An Act to protect access to confidential health care, a key priority for Health Care For All. The bill would fix a crucial barrier to accessing health care by ensuring that when multiple people are on the same insurance plan, confidential health care information is not shared with anyone other than the patient.

Health insurers routinely send out explanation of benefits (EOB) forms detailing the type and cost of medical services received to the primary subscriber of a health insurance plan, not the individual patient who accessed services. Sensitive health information may be disclosed in these forms, violating the basic right to privacy for anyone enrolled as a dependent on another’s policy, such as a young adult, minor, or spouse. S. 2318 would address this problem by allowing patients to choose where and how they receive explanation of benefits (EOB) forms.

During the Senate session, Senate Ways and Means Chair Karen Spilka, the bill’s lead sponsor in the Senate, spoke passionately in support of the bill’s passage. She explained that patient confidentiality is a fundamental element of the patient-provider relationship and is essential in helping patients feel comfortable accessing care and sharing information with their health care providers. Out of fear that a parent or spouse may see an EOB, young adults or survivors of domestic violence may not seek needed treatment at all, she said.  While some health plans already take steps to ensure confidentiality, this bill would ensure that all health plans do so and in turn would help many individuals across the Commonwealth.

Senator Eldridge, Chair of the Joint Committee on Financial Services, which had previously given the bill a favorable report, also spoke in support of the bill. He reminded his fellow Senators of the compelling testimony from a number of young people at the bill’s public hearing. He described the bill as an important way to work towards continuing to improve our health care system, as keeping health care information confidential is extremely important to every patient in Massachusetts.

The bill was then advanced on a unanimous voice vote and ordered to a third reading, and will likely taken up for a final vote next week.  We thank both Senator Spilka and Senator Eldridge for their leadership in ensuring critical confidentiality protections for patients in Massachusetts and urge the full Senate to pass this legislation next week.

      -- Alyssa Vangeli & Jessica Imbro

February 21, 2016

The remaining uninsured in MassachusettsLast week, the Blue Cross Blue Shield of Massachusetts Foundation and the University of Massachusetts Medical School released a report entitled “The Remaining Uninsured in MA: Experiences of Individuals Living without Health Insurance Coverage” (read the report here). Massachusetts continues to have the lowest uninsured rate in the nation, with some 97% of residents covered. However, about 200,000 people of diverse age, race and employment status remain uninsured. The goal of this study was to figure out the reasons why people remained uninsured and help inform policy suggestions which would help them receive coverage in the future.

The report authors spoke to a sample of uninsured people from seven counties in the state and developed the following key findings;

First, health care costs continue to be prohibitive. One of the most cited reasons that people gave for being uninsured was the cost. Some people weren’t eligible for their employer’s insurance, and other were not eligible for subsidies. Some 58% of respondents said they had had coverage at some point in their adult lives, but changing circumstances had dissuaded them from applying. Some said that they let their coverage lapse because they said they didn’t use it enough to justify the cost, while others simply became ineligible for employer-provided insurance. One respondent said that the cost of the penalty was less than the cost of insurance itself, and so they decided to simply pay the fine.

Another key point here is that a vast majority (73%) of the people surveyed said that they considered themselves to be in very good health, despite that slightly more than one third has one or more chronic conditions. Still, it would seem that some people were willing to hedge their bets by remaining uninsured, counting on good health to compensate for their lack of insurance.

Some other important aspects were related to communication; the process of applying was widely reported to be confusing and complex, and would be greatly simplified by having personal assistance, in people’s primary language. Having access to this would be even better if it is available in convenient location such as “health clinics, hospitals, nonprofit organizations, unemployment offices, and local businesses” that have evening and weekend operating hours, additional appointment times and more staff to assist.

Some respondents also reported losing their health insurance through state programs like MassHealth because they did not realize they needed to take any action to renew their membership. In this area, better communication with enrollees is necessary.

Secondly, the value of health insurance was lost on no one. Almost every person contacted indicated that they wanted health insurance coverage, and certainly understood the value of it to their overall wellbeing. Most people indicated that that the insurance provided a sense of security and that the lack on insurance was reflected in the way that people interacted with their care. People without insurance said that being uninsured limits “when they can get care, where they can get care, and what type of care they receive. Nearly a third said they were unable to get care when they needed it and that not having insurance limited their access to specialty care, routine tests, and preventive screenings”. Almost one third said that they were unable to get care when they needed it. While some people reported that they didn’t use it enough to justify the costs, the lack of insurance meant either not receiving or putting off necessary and preventative care.

The study notes that community health services such as free clinics and community health centers provide necessary access points for uninsured, especially undocumented, people in the Commonwealth. Additionally, the report supports the value of enrollment events and in-person assistance to help insure people and recommends possibly working with unemployment offices to help those who are looking for insurance outside of the open enrollment period.

The report closes with a note that lowering Massachusetts’ already low uninsured rate will be difficult, but that by learning from the experiences of those people, we can do what is possible to get the number down to 0% uninsured.

                  -Sara O’Brien

February 16, 2016

Last week, the board of the Massachusetts Health Connector met to discuss results from the 2016 open enrollment period and voted to release the proposed 2017 Affordability Schedule for public comment. Materials from the meeting can be found here.        

The meeting started with a warm send-off for Dolores Mitchell, who is retiring from a long career in public service. Mitchell ran the Group Insurance Commission (GIC) for nearly 30 years and served as a Connector Board member since its inception in 2006. Throughout her career, she has been leader in advancing access to affordable health care in the Commonwealth.

Health Connector Deputy Executive Director Ashley Hague and Chief Operating Officer Vicki Coates shared highlights from the 2016 Open Enrollment period, which ran from November 1, 2015-January 31, 2016. They started by looking at how the Health Connector made enrollment a smoother process by using direct mailing campaigns, logging additional call center hours, and setting up four additional walk-in centers across the state, among other efforts.

2016 Open Enrollment Update

February 2, 2016

ACO

Health Care For All submitted detailed comments last week to the Health Policy Commission on their proposed certification standards for ACOs. In our introduction to our comments (submitted in conjunction with Health Law Advocates), we wrote that

The Health Policy Commission has an opportunity to promote approaches to payment reform that fundamentally transform the way care is delivered. ACOs should deliver high quality, high value care that treats the individual as a whole person. ACOs should ensure coordination of care, improved communication, member support and empowerment, and ready access to health care providers, services and community-based resources and supports.

You can read a detailed summary of our comments, as well as download our complete submission, here.