A Healthy Blog

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

House Begins Budget Debate - Call Your Representative to Protect Our Health

House Begins Budget Debate - Call Your Representative to Protect Our Health

April 25, 2011

If it’s the week after April school vacation, then this is the week for the Massachusetts House to consider amendments to its version of the budget for the next fiscal year (resources: comprehensive House budget summary from Mass Budget and Policy Center and summary of the health provisions (pdf) from Mass Medicaid Policy Institute). The budget debate is expected to take all week, and most years the health-related amendments don’t come up until near the end of the debate.

The loss of federal stimulus aid and the ramp-up of the recovery will result in a $1.9 billion gap next year between expected revenue and costs. With new revenues ruled off the table, the House Ways and Means proposal relies on budget cuts to close this gap. For health care, MassBudget calculates that overall health spending will be down 3.7%, around $547 million, compared to last year. The House proposal spends about $70 million less than the Governor recommended.

The result is drastic, painful cuts.

The most dramatic cut is the elimination of the Commonwealth Care Bridge program. If this were to stand, some 20,000 legal immigrants would lose their coverage. Eliminating coverage to these Bay Staters would be a dramatic step back from the gains of health reform. Eliminating coverage just shifts costs to the unmanaged Health Safety Net program, already severely underfund. We strongly oppose this cut, and HCFA and the ACT!! Coalition is supporting amendment 750, filed by Representative Toomey, to continue the program.

We’re also actively working on the following key amendments (the text of all amendments is here):

  • Adult dental services: Last year MassHealth eliminated many dental services for adults. Amendment 203 (Scibak) would start restoring full dental benefits to particularly vulnerable groups, including pregnant women, people with developmental disabilities, or those with HIV/AIDS. Amendments 345 (Scibak), 107 (Wolf) would also make progress in restoring some or all of the adult dental services eliminated last year. The mouth is an integral part of the body, and reducing dental benefits leads to increased long-term health costs.
  • Public Health: Adequate investments in public health leads to improved overall health and decreased future costs. HCFA strongly supports amendments 224 (Schmid), which restores some funding for health promotion and disease prevention, amendment 373 (Malia), which supports substance abuse and recovery follow-up programs, amendment 611 (Kafka), to prevent deep cuts to cost-effective early intervention services for children, and amendment 712 (Provost), which provides some minimal funding for health care quality efforts and the Office of Patient Protection.
  • Prescription Drugs: HCFA supports amendment 205 (Lewis), which prevents the elimination of the successful Academic Detailing program that provides objective education to counter biased marketing from the pharma industry. We also oppose a number of amendments that would reverse our gains by opening up avenues for cost-increasing marketing ploys by pharma, including amendments 16 (Jones), 230 (Bradley), and 471 (Michlewitz).
  • Improve Health Reform: Amendment 268 (Holmes) reduces the costly in-and-out churn among families on MassHealth by allowing for 12 months of ongoing assistance, and amendment 744 (Cariddi) funds the MassHealth Outreach and Access to Care grants, critical to keeping people covered.
  • Health Equity: Amendment 429 (Rushing) allows funds to go for the operation of the Office of Health Equity within EOHHS.

In addition to these, a number of amendments have been filed to move all MassHealth members to managed care organizations. These amendments ignore the fact the MassHealth is in the process of seeking more active care management of members in the Primary Care Clinician plan. We believe this process ought to be allowed to work before dramatic changes are made to the structure of MassHealth.

Call your Representative. Contact your Representative now on these important amendments. A phone call is best - the House switchboard is at 617-722-2000.
-Brian Rosman and Courtney Mulroy