April 2017

April 27, 2017
The American Health Care Act (AHCA) was first introduced by House Speaker Paul Ryan on March 20th, 2017. The latest proposal keeps all of the bad features of AHCA, such as the $880 billion cuts to Medicaid and plans to strip more than 20 million people of their health insurance. Added to that it would allow states to gut the main consumer protections of the ACA and return to a time when insurers could discriminate against those living with preexisting conditions – charging them higher premiums and selling them plans that don’t meet their health needs by limiting benefits and increasing out-of-pocket costs.

Even though Congress is trying to avert a government shutdown, the health care debate remains critically important as Speaker Ryan roams the halls looking for votes in support of his bad bill.

We have a real chance to stop this. 
In Massachusetts, our congressional delegation has already committed to defend our gains in health care, but we can still make a difference in this battle. 
We're asking everyone to please contact your friends and family who live in states with Republican US representatives. You need to ask them to get in touch with their members of Congress to ensure that they don't support this dangerous bill!


Tell them how health reform has been a success, and direct them to http://bit.ly/CallCongressCC

Thank you to our partner organization Community Catalyst for the information, resources, and leadership they provide in this fight. 
April 25, 2017

Yesterday, the full House began the FY 2018 budget deliberation process on Beacon Hill. As the amendment process moves forward, we at HCFA are working with lawmakers, advocates, providers, faith groups, consumers, and other health stakeholders to protect funding for consumer based health care programs in the state budget and to protect MassHealth and other critical pieces of the Commonwealth’s health infrastructure.

[See our complete budget amendment fact sheet here]

HCFA Supports:

  • Investing an additional $5 million in the Children’s Medical Security Plan and directing EOHHS to plan for the lifting of caps on benefits for covered children (Amendment #1077/Rep. Barber)
  • Ensuring that MassHealth CarePlus enrollees continue to have access to non-emergency medical transportation (Amendment #100/Rep. Gentile)
  • Reinstating coverage for periodontal disease (a chronic bacterial infection of the gums and teeth) services for adult MassHealth enrollees (Amendment #439/Rep. Scibak)
  • Restoring full dental benefits for adult MassHealth enrollees (Amendment #419/Rep. Pignatelli)
  • Allocating $500,000 to fund academic detailing, a physician education program on cost-effective pain management medications (Amendment #797/Rep. Benson)
  • Increasing funding for the Department of Public Health’s Office of Oral Health (Amendment #117/Rep. Scibak)
  • Allocating $300,000 for the Forsyth Kids program, which provides school-based oral health care to 1,700 underserved children across the Commonwealth (Amendment #234/Rep. Crighton)
  • Establish the Prevention and Wellness Trust Fund as a permanent program with a dedicated revenue stream (Amendment #24/Rep. Vega)
  • Investing $301,500 to expand screening, brief intervention, and referral to treatment programs in schools targeted at addressing adolescent alcohol and drug use (Amendment #860/Rep. Khan)
  • Funding and maintaining the successful Mental Health Advocacy Program for Kids (MHAP) that helps children involved with the juvenile justice system (Amendment #351/Rep. Golden)
  • Creating a common application for SNAP and MassHealth benefits to close to SNAP Gap and expand access to benefits for low income residents (Amendment #31/Rep. Livingstone)

HCFA Opposes:

  • Creating a MassHealth Control Board charged with slashing MassHealth spending with no consideration for improving health outcomes for enrollees, no legislative oversight, and no MassHealth member/consumer representation (Amendment #876/Rep. Lyons)
  • Targeting low income residents by instituting MassHealth work requirements, charging premiums, and barring MassHealth eligible workers with employer sponsored insurance from enrolling in wrap around coverage (Amendment #878/Rep. Lyons)
  • Capping MassHealth spending at 30% of the total state budget, effectively forcing massive cuts in state Medicaid spending while only passing savings on to the federal government (Amendment #880/Rep. Lyons)

We encourage you to contact your state representative to express your support/opposition to the above amendments.

                                                                                                                                                                                                             Alec Lebovitz

April 17, 2017

The Blue Cross Blue Shield of Massachusetts Foundation has just released a detailed set of reports on uninsurance rates in the state, The Geography of Uninsurance in Massachusetts, 2011-2015. The report is based the five years of data from the census’ American Community Survey (ACS), which surveys 2 million households annually to identify uninsured residents.

Since the implementation of Chapter 58 our 2006 state health reform law, the insurance rate has increased dramatically. In 2015, 97.2% of the population had access to health care. However, “The Geography of Uninsurance, 2011-2015” highlights those areas in the state where the percentage of insured residents is much lower than the median. The wide variation is shown in this map:

Wide variation in insurance coverage in Massachusetts
The table below provides a list of municipalities ranked by the uninsurance rate (%) where HCFA has targeted our outreach and enrollment efforts:


Total Population (#)

Uninsured (#)

Uninsurance Rate (#)

































Health Care For All’s HelpLine provides multilingual and culturally competent direct services as a navigator organization to improve access to health insurance and care for underserved communities such as the ones listed above. As part of this work, HCFA has deployed ethnic media campaigns and hosted successful enrollment events and sessions in towns with both high uninsurance rates and immigrant populations. We have also developed a partnership with the Edward M. Kennedy Community Health Center in Framingham to help residents navigate their health insurance options during Open Enrollment that will continue in 2017-2018, targeting Spanish and Portuguese speakers in the region.

If you know someone who is uninsured or needs help navigating the complicated healthcare system, please connect them to HCFA’s HelpLine at 1-800-272-4232.

April 13, 2017

The state House of Representatives released their draft budget this week. The budget funds the state's MassHealth and other health programs, and includes many provision supported by HCFA. Our friends at the Massachusetts Law Reform Institute released an outstanding summary of the provisions affecting low income residents, including MassHealth and other health concerns. House budget debate starts on April 24.

Net state spending for MassHealth is just 14% of state budget

We want to offer an important correction to a misleading fact often cited in the press. It is claimed that MassHealth, our Medicaid program, consumes 40% or more of the total state budget, leading policymakers to decry out of control spending for Medicaid. Yet this statistic ignores the fact that that the vast majority of that spending comes from the federal government, and doesn't come out of state revenue. It's just a pass-through.

The real numbers are that Medicaid costs make up just 14% of state spending from state revenue. The rest is all federal money, that comes into Massachusetts, and is then spent in our economy, benefiting Mass residents. See the graphs on this presentation from the Blue Cross Foundation, chart 5, reproduced above. So, claiming that Medicaid costs us 40% of the budget is very misleading

HCFA is pleased that the House budget proposal includes a reinstatment of the state's employer responsibilty law. This will assess a fee on large employers who do not provide health insurance coverage to their workers. A similar fee was included in chapter 58, the 2006 health reform passed under Governor Romney, and was also part of the Affordable Care Act. The state fee was repealed several years ago, and with the ACA fee in danger of being repealed, or nor enforced, it's important for the state to step in and make sure that employers are prompted to provide coverage.

HCFA is supporting a number of important amendments to improve the budget. Please, call your state Representative, and urge him or her to support HCFA's budget priorities. Here's our list:

Improve Children's Health Coverage

Thousands of children who are not eligible for MassHealth and do not have access to private health insurance through their parents can get basic coverage through the Children's Medical Security Plan (CMSP). However, CMSP benefits have strict limits on coverage that are inadequate to keep a child healthy; for example, a $200 limit on prescription drugs and a 13-visit limit on mental health services. The FY2018 budgets proposed thus far cut funding for CMSP from $17.4 million to $12.4 million. Please support Rep. Barber's amendment to restore $5 million in funding for CMSP and to direct EOHHS to develop a plan to improve the scope of benefits (adding language and $5 million to line item 4000-0990).

Ensure Access to Transportation for Medical Appointments

Non-emergency medical transportation provides access to and from medical appointments for MassHealth enrollees who do not have other means of transportation. EOHHS has indicated it plans to seek a waiver to eliminate this benefit except for travel to substance use disorder (SUD) treatment services for MassHealth CarePlus (Medicaid expansion) enrollees. About 13,000 MassHealth CarePlus enrollees used non-emergency medical transportation for non-substance use disorders (SUD) services last year. Please support Rep. Gentile's amendment (#100) to ensure that MassHealth CarePlus enrollees continue to receive appropriate transportation to all necessary medical appointments (adding language to line item 4000-0940).

Restore Periodontal Treatment Coverage for Adult MassHealth Enrollees

Periodontal disease is a chronic bacterial infection of the gums and bone that surround teeth. When left untreated, this disease causes irreversible gum and bone loss leading to eventual tooth loss and also directly impacts chronic disease outcomes including those of diabetes, heart disease, and stroke. Periodontal disease can also lead to low birth weight and premature birth. Therefore, coverage for the treatment of periodontal disease is critical to improving the oral and general health of the adult population. Please support Rep. Scibak’s amendment to restore coverage for periodontal services for adult MassHealth enrollees (adding language and $10 million to line item 4000-0700).

Plan for Full Restoration of MassHealth Adult Dental Benefits

More than 1 million people, including 149,000 seniors and 245,000 people with disabilities, are without access to dental care beyond cleanings, fillings, extractions, and full dentures. Without access to appropriate dental care, many people living with chronic illnesses such as diabetes or hypertension see their conditions worsen. Those with oral health issues that may have been easily resolved with a simple procedure may require far more invasive and costly treatments. Please support Rep. Pignatelli’s amendment directing EOHHS to develop a plan to fully restore dental benefits for adult MassHealth enrollees (adding language to line item 4000-0700).