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.
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 The state fee was repealed several years ago, and with the ACA fee in danger of being repealed, or nor enforced, it's important for the state to step in and make sure that employers are prompted to provide coverage.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).