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Massachusetts health care — wonky, with a healthy dose of reality

Committee Hears Childrens, Oral Health Bills

Committee Hears Childrens, Oral Health Bills

July 16, 2009

The Health Care Financing Committee held its last scheduled hearing on primary jurisdiction bills today. Included were key HCFA priority bills on children's health and oral health (see our photos here).

Kids: The success of Massachusetts in extending health coverage to virtually all children is laudable, but an insurance card alone is not enough to guarantee care. Nearly 16,000 children in the Commonwealth access care through the Children’s Medical Security Plan (CMSP), but the scope of services offered under this program are frequently insufficient to fully address their health needs.

CMSP is a program specifically designed to cover children who do not have access to private coverage and who are ineligible for other public programs. However, CMSP has caps on essential provisions of care that significantly limit the a family’s ability to make sure their child is healthy:

  • CMSP limits prescription drug coverage to $200 per year. A single ear ache alone would easily exhaust this benefit;
  • Durable medical equipment is likewise capped at $200 – a level insufficient to cover major equipment such as a wheelchair or a breathing machine;
  • Paradoxically, although CMSP covers vision and hearing screening, it does not cover eyeglasses or hearing aids.

At today’s Health Care Financing Committee hearing (video hightlights above), Senator Sonia Chang-Diaz, Dr. Sean Palfrey, Toby Guevin, and Patty Glidden all testified in support of H. 1087 / S. 537, An Act Relative to Equitable Health Coverage for All Children.

Dr. Palfrey and Patty Glidden in particular cited specific cases from their experience as medical professionals of children who went over their caps and were put in difficult positions.

Patty spoke of a boy she works with at the Martha Elliot Health Center in Jamaica Plain who requires expensive medication to control his asthma. $200 covers only a few months of medication, forcing the family to seek out samples or make difficult family budget decisions.

Dr. Palfrey told the committee about a girl who receives care at Boston Medical Center. The girl has kidney disease, which requires her to self-catheterize several times a day. The $200 cap on durable medical equipment is insufficient for the year. The family tried to sterilize the equipment themselves to make it last longer, but the girl came down with a serious infection, resulting in an expensive hospitalization.

H. 1087 / S. 537 would eliminate the current two-tiered system of care that we now have for children and eliminates the unrealistic caps in CMSP.

Oral HealthTwo important oral health bills were heard. Both aim to improve overall health by increasing access to important preventive and restorative oral health services.

H. 1100 / S. 31, An Act Relative to Equitable Dental Reimbursement Rates for Services Provided to Publicly Aided Patients, sponsored Senator Harriette Chandler and Representative John Scibak, will increase access by bringing reimbursement rates for MassHealth dental services to an equitable level.

H. 1101 / S. 1038, An Act to Include Dental Benefits in All Commonwealth Care Plans, is also being co-sponsored by Senator Harriette Chandler and Representative John Scibak. This bill will include dental benefits in Commonwealth Care plans for adults between 100% and 300% of the federal poverty level. Dental benefits are not included in Commonwealth Care plans for individuals with incomes above 100% but below 300%. This bill would require that plans offered to adults with incomes below 300% include comprehensive dental benefits.

Many speakers stood up to remind legislators that dental insurance is health insurance! Senator Harriette Chandler, Representative John Scibak, and Representative Ellen Story all testified in support of the bills. HCFA also helped organize a diverse panel to emphasize several important aspects of this legislation. Dr. Lynda Young, a pediatrician in Worcester, MA, spoke about the importance of oral health to overall health, and the huge impact that dental disease can have on all aspects of life. Former Massachusetts Representative Kathy Teahan discussed the negative impact that poor oral health can have on businesses and the economy, and the importance of access to sustaining a robust workforce in the Commonwealth. Lastly, Dr. Cynthia Stevens, the VP of Dental Services for Community Health Connections Health Centers in Fitchburg and Gardener talked about how increasing reimbursement rates is essential to keeping the doors of health safety net and health centers open. The speakers all did fantastic jobs of highlighting how these two bills will help improve the overall health of the Commonwealth by making sure that we are providing whole-body coverage to our residents.
- Matt Noyes and Christine Keeves