With the launch of a new legislative session, we at HCFA are excited to announce a new legislative agenda that advocates for a more effective and consumer friendly health care system here in the Bay State.
HCFA worked with a diverse group of legislators in both the House and Senate to file a broad package of legislation. The proposed legislation includes the following proposals:
Health Care Affordability
• Reduce Out-Of-Pocket Health Care Costs: H. 522/S. 546 (Rep. Farley-Bouvier & Sen. Lewis) (Financial Services): Increasing co-pays and deductibles have become an obstacle to good health care in MA. As out-of-pocket costs rise, patients may be less likely to access care or follow prescribed treatments and medications, especially patients with low incomes or chronic conditions. An Act to Keep People Healthy by Removing Barriers to Cost-Effective Care will eliminate cost-sharing for high-value services and drugs, thereby improving adherence and patient outcomes.
• Preserve Affordable Health Coverage: H. 592/S. 630 (Rep. Balser & Sen. Jehlen): Access to affordable health coverage is the cornerstone of successful health reform policy. An Act to Restore Affordable Health Connector Coverage ensures that premiums and cost-sharing remain affordable for individuals who receive subsidies to purchase health insurance through the Health Connector. This is especially important in light of recent ConnectorCare premium increases and impending federal changes to the Affordable Care Act.
Health Care Confidentiality
• Enhance Confidentiality in Medical Care: H. 2960/S. 591 (Rep. Hogan & Sen. Spilka): Health insurers routinely send an explanation of benefits form (EOB) to the primary policyholder detailing medical services received each time an enrollee on the plan, such as a spouse or young adult, accesses care. The EOB may contain sensitive health care information and can unintentionally compromise patient confidentiality. An Act to Protect Access to Confidential Healthcare would ensure that when multiple people are on the same insurance plan, confidential health care information is not shared with anyone other than the patient.
Children’s Health Access
• Improve the Children’s Medical Security Program: H.2216/S. 32 (Rep. Malia & Sen. DiDomenico): The Children’s Medical Security Program (CMSP) provides basic coverage to children who are otherwise ineligible for other public health insurance programs. With strict limits on covered services and coverage amounts, CMSP coverage may not provide sufficient benefits to keep a young person healthy. An Act Improving the Children’s Medical Security Plan and Simplifying the Administration Process gives EOHHS the flexibility to address the health needs of children by eliminating service caps, while staying within the program’s annual appropriation.
• Ensure Continued Coverage for Children: H. 598/S. 647 (Rep. Cronin & Sen. L’Italien): The Children’s Health Insurance Program (CHIP) provides comprehensive, affordable health coverage to uninsured children and pregnant women who have lower incomes, but make too much to qualify for Medicaid. Federal funding for CHIP runs out after September 30, 2017, which would cause about 160,000 children and youth and thousands of pregnant women to lose their health insurance. An Act to Ensure Continued Health Insurance Coverage for Children ensures that CHIP enrollees maintain coverage regardless of federal action on the program.
• Increase Access to Children’s Mental Health Services: H. 488/S. 547 (Rep. Balser & Sen. Lewis): An Act to Increase Access to Children’s Mental Health Services in the Community requires coverage for community and home-based behavioral health care services (“wraparound care”) for children and adolescents with mental health disorders who are covered by commercial insurance. Currently, these services are only available to children with MassHealth and their families, through the Children’s Behavioral Health Initiative (CBHI). Families with commercial insurance either go without these services, or use “secondary MassHealth” to obtain the services.
Dental Care Access
• Expand Dental Access in Massachusetts: H. 2474/S. 1169 (Rep. Pignatelli & Sen. Chandler) (Public Health): The most vulnerable populations in Massachusetts often go without oral health care due to lack of easy access to a dentist. An Act Authorizing Dental Therapists to Expand Access to Oral Health authorizes a new type of midlevel dental professional, the dental hygiene practitioner (DHP). DHPs present a critical opportunity for our state to close gaps in dental access for seniors, low-income families, children and people with special needs.
• Restore MassHealth Dental Benefits: H. 1225 (Rep. Scibak): An Act Relative to the Restoration of MassHealth Adult Dental Benefits will restore full MassHealth dental benefits to more than 800,000 individuals, including 120,000 seniors and 180,000 people living with disabilities. Left untreated, dental disease can lead to systemic infection, hospitalization, and the worsening of other medical conditions. Oral health is an integral part of overall health and should be included in health coverage.
Health Insurer Provider Directories
• Ensure Accuracy of Health Plan Provider Directories: H. 2947/S. 528 (Rep. Barber & Sen. Flanagan): Families and individuals seeking care in MA are often unable to find accurate, reliable information about the provider network available through their health plan. Insurers do not regularly update provider directories, so patients or their families cannot find a provider when they need one. An Act to Increase Consumer Transparency about Insurance Provider Networks requires insurers to meet reporting and transparency standards and reduces barriers to accessing out-of-network care when the plan lacks appropriate in-network providers.
• Increase Prescription Drug Cost Transparency: H.1228/S. 652 (Rep. Tosado & Sen. Montigny): Prescription drug prices continue to rise, increasing the cost of health insurance for individuals, families, employers and the state. An Act to Promote Transparency and Cost Control of Pharmaceutical Drug Prices will shed light on the true costs of drug development. The House and Senate bills, while slightly different, both will provide open, public transparency around how much drugs actually cost to manufacture, how much people in other countries pay, the true price charged for the drug in Massachusetts, and the research and advertising costs for the most expensive drugs.
• Ensure Provider Access to Unbiased Information about Prescription Drugs: S. 1215 (Sen. Lewis): An Act to Reduce Healthcare Costs by Promoting Non-Biased Prescriber Education will address the problem of rising prescription drug costs by creating an “academic detailing” program to respond to pharmaceutical industry efforts to market only the newest and most expensive prescription drugs to prescribers. The academic detailing program would consist of a network of physicians, healthcare providers, insurers, and other stakeholders tasked with delivering unbiased, evidence-based information to prescribers regarding prescription drugs and other therapeutically equivalent alternatives for potential use by their patients.
• Support Prevention and Wellness: H. 2480/S. 643 (Reps. Vega & Chan, Senators Chandler & Welch): The Prevention and Wellness Trust Fund (PWTF) invests in evidence-based community interventions that keep residents healthy and safe and is helping to transform the linkages between clinical care and community-based services. An Act to promote public health through the prevention and wellness trust fund extends funding for the PWTF, which would otherwise sunset in mid-2017.
For more information, please contact Brian Rosman,
Director of Policy and Government Relations:
HCFA is asking constituents to call their legislators and ask them to cosponsor any or all of these bills.