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HCFA's 2009 Legislative Agenda - Parts 1 and 2

HCFA's 2009 Legislative Agenda - Parts 1 and 2

January 19, 2009

The 2008 legislative session was a great success for HCFA. In October, we distributed Healthy Victories (pdf), a newsletter detailing our successes. The latest addition to that list is Chapter 530 of the Acts of 2008, the omnibus oral health law signed by the Governor on January 15th. Looking ahead, HCFA and its coalitions have finalized their legislative priorities for the 2009-2010 session. Over the next few days each of our coalitions will highlight their legislative priorities. First up, bills filed on the issues of children's health and health reform. Children's Health Massachusetts has much to be proud of in providing health care to children. We rank #1 nationally, with only 1.2% of the Commonwealth’s children lacking health coverage. Still, there remains work to be done. There are improvements that can be made to the children’s health system, particularly in terms of eligibility and quality of care. This legislative session, the Children’s Health Access Coalition (CHAC) is supporting three pieces of legislation:

  1. Extend MassHealth coverage through age 20. Currently, children receiving MassHealth lose their coverage when they turn 19. However, if a young person is receiving MassHealth, it is likely that their circumstances have not changed dramatically on their nineteenth birthday and that they would benefit from continuing this coverage. MassHealth premiums and co-payments are significantly lower than those under Commonwealth Care, and remaining on MassHealth provides these transition-aged youth with continuity of care that is greatly beneficial. This legislation is being sponsored by Senator Tom McGee and Representative Danielle Gregoire.
  2. Improve services in CMSP. The Children’s Medical Security Program (CMSP) is a state-funded health plan targeted at children who would otherwise be ineligible for other public programs. However, the services available under CMSP are very poor and have caps that are insufficient for many children - $200 annual max on prescription drugs, $1000 annual maximum in emergency care, no coverage for eyeglasses or hearing aides. As any parent will tell you, $200 will cover treatment for a single earache. After that, there is no coverage left. This bill would raise the standards of care to match those of MassHealth, thereby eliminating the disparity inherent in a two-tiered coverage system. Senator Sonia Chang-Diaz and Representative Liz Malia are the lead sponsors of the bill.
  3. SCHIP continuous eligibility. Health coverage under SCHIP and MassHealth is available to children in Massachusetts who are from families living below 300% of the federal poverty level (FPL). Currently, a child will lose coverage if his or her family’s income rises above this level at any time after becoming eligible. For many families, income fluctuates over the course of a year. When this happens to a family of 4 making less than $63,000 a year, children cycle on and off of MassHealth coverage. The federal government allows states to establish 12 month continuous eligibility under these programs, meaning that once a child is deemed eligible for SCHIP or Medicaid, they maintain that eligibility for 12 months regardless of their family’s income. Maine, New York, New Jersey, and Pennsylvania are among the 29 states have implemented this policy. Ongoing 12 month eligibility, in addition to benefiting children through guaranteed coverage, lowers government administrative costs and helps providers by assuring them of reimbursement for their services. This legislation is being led by Senator Jen Flannagan and Representative Ellen Story.

CHAC has been remarkably successful over the years in advocating for legislation to improve the health of children in Massachusetts. The Coalition looks forward to the new legislative session as an opportunity to continue its work. For more information, contact Matt Noyes. Health Reform Look at the numbers: 97.4% coverage; 440,000 people covered; 75% support—in the past two years, Massachusetts health reform has been successful in myriad ways. Yet the law and its implementation are not perfect. There are gaps, glitches, and structural inequalities. The ACT!! Coalition is supporting legislation that will address these issues. The following bills will help Massachusetts continue to move closer to our goal of ensuring quality, affordable health care for all residents.

  1. An Act Strengthening Health Reform: Sponsored by Senator Richard Moore and Representative Stephen Kulik, this bill seeks to address gaps in health coverage by:
    • Aligning the Commonwealth Care application and appeals processes with MassHealth to ensure continuity of coverage;
    • Prohibiting lifetime caps in all Massachusetts health insurance plans;
    • Making Health Safety Net retroactive coverage consistent for all eligible patients;
    • Granting more flexibility to the Office of Medicaid to provide the most cost-effective health care to elderly and disabled legal immigrants; and
    • Strengthening and codifying the Health Care Reform Outreach and Education Unit and the MassHealth Outreach Grant program to help Massachusetts residents navigate the health care system and retain coverage.
  2. An Act Relative to Health Care Affordability: Championed by Senator Mark Montigny and Representative John Scibak, this bill will address affordability and tackle health care costs by:
    • Expanding the definition of affordability to accurately reflect all health care costs consumers face – guaranteeing that the coverage Massachusetts residents obtain coverage is truly affordable to them; and
    • Strengthening regulation of health insurers by creating a new Division of Health Insurance to enforce cost control initiatives and assure that health premiums are kept as affordable as possible.


Health Care For All and a number of partners are supporting a third health reform bill.


  • An Act Relative to Shared Responsibility in Health Reform: Led by Senator Mark Montigny and Representative Stephen Kulik, this bill honors health reform’s framework of shared responsibility by raising revenue for health reform from employers who do not provide minimal health benefits. This bill offers four methods for increasing employer responsibility, to even the playing field for non-offering employers and to reimburse the state for part of its cost in covering workers:
    • Assess employers who have workers on Commonwealth Care a portion of the cost of the benefits provided to their workers; these employers do not offer coverage to their workers:
    • Increase the Fair Share Contribution established under Chapter 58; the current level, $295 a year, is less than a tenth of the cost of coverage provided to uninsured workers by the Commonwealth;
    • Require employers to spend a minimum hourly amount toward employee health coverage; this model has proven successful in San Francisco; and
    • Assess employers a payroll tax to cover their employees’ health care; this model was originally supported by ACT! and was approved by the House in 2005.

If you have any questions about the health reform priorities, please contact Suzanne Curry.