House Budget Debate: HCFA Priorities
The House budget debate turns to health care-related issues today. For the past week HCFA and the coalitions we help lead have been pounding the halls of the State House seeking support for budget amendments that strengthen our health care system and protect access to affordable coverage. We have also opposed a number of amendments that would weaken our important restrictions on inappropriate prescription drug marketing.
Here are some of the issues we have been working on:
MassHealth adult dental benefits were not restored in the House Ways & Means budget. Representative John Scibak filed two amendments (417 and 421) that will work together to restore fillings. Representative Scibak’s colleagues rallied behind him in support of the amendments, with 64 of them joining him as cosponsors. This is just the first step in the process of incremental restoration, and both HCFA and the Oral Health Advocacy Taskforce remain steadfast in their commitment to the full restoration of MassHealth adult dental benefits. In the meantime, restoring fillings will allow dentists to remove decay and stop infections, which will help to prevent serious health problems and costly ER visits.
Since the recession, MassHealth’s enrollment has been growing, yet its administrative resources have been shrinking. There has been a substantial increase in processing backlogs and phone wait times at MassHealth. Delays in eligibility determinations and coverage renewals impede access to care for thousands of Massachusetts residents. Additional investment in the MassHealth operations, customer service and information technology functions will begin to address these problems and ensure timely enrollment and re-enrollment for MassHealth and Commonwealth Care members, while beginning to implement payment reform strategies and the Affordable Care Act. HCFA is supporting two amendments introduced by Rep. Aguiar (729 and 732) to improve MassHealth operations and systems capacity.
The MassHealth Outreach & Access to Care Program supports local consumer-focused organizations and community health centers to help Massachusetts residents navigate the health care system. In 2011, the grants enabled 51 organizations across the state assist over 272,000 Massachusetts residents. Without this funding, many community organizations would be forced to lay off workers, reduce services, or even shut down. Rep. Andrews has proposed an amendment (497) that would fund the program at $2.5 million.
Since 2009, the state budget has authorized the use of EOHHS administrative funds for the Office of Health Equity. The Office provides a central focus for disparities work across all of the state's health agencies, and ensures that racial and ethnic disparities are considered whenever policy is being discussed. This year's House budget leaves out language authorizing funding for the Office of Health Equity. Representatives Rushing and Sanchez have each introduced amendments (437 and 379, respectively) that would add the language. These amendments do not add to the state budget, but demonstrate the importance of work to reduce disparities.
The Division of Health Care Quality at the Department of Public Health works to make sure the quality of health care that everyone receives in MA is the best it can be. The Division licenses and inspects hospitals, nursing homes, and other health care facilities, receives and investigates complaints, publicly reports and works to reduce infections and serious events, and participates in many collaborative quality improvements initiatives in MA. Rep. Provost has filed two budget amendments to provide needed funding to the Division. Amendment 335 would increase funding to $4.2 million. This line item funds the important facility licensure work of the Division. Amendment 332 would increase funding in line item 4510-0710 to $6.3 million. This line item funds all of the other work of the Division and cuts would greatly impact its ability to ensure high-quality care is provided across the Commonwealth. HCFA is also supporting amendment 377, filed by Chairman Sanchez, which would increase funding for the Department's Health Promotion and Disease Prevention work to $3.4 million.
Affordable Prescription Drugs
The Pharmaceutical and Medical Device Gift Ban law prohibits drug and medical device companies from providing gifts, such as meals or entertainment, to doctors, nurses, and other health care providers, as part of their marketing practices. Repealing the Gift Ban law would allow drug and medical device companies to spend unlimited dollars on gifts and meals to prescribers, calling into question the integrity of doctor-patient relationships. We support an amendment filed by Rep. Lewis (406) to strike outside section 46 and preserve the pharmaceutical and medical device gift ban and disclosure law; and oppose all amendments (59, 60 and 318) that would weaken the pharmaceutical gift ban and disclosure law.
Rx Drug Coupons
Prescription drug coupons are an extremely successful marketing strategy used to increase pharmaceutical company profits at the expense of health care consumers, while causing drug costs to soar. Drug companies use coupons to entice consumers to purchase a more expensive name brand drug, which may have cheaper and equally effective generic or therapeutically equivalent alternatives. While some consumers temporarily pay lower co-pays, coupons are typically available only for a limited supply of high cost brand drugs, leaving patients with higher copays for the remaining duration of their prescriptions. Moreover, the use of coupons would lead to increased long-term costs for all consumers as insurers and purchasers pay more for the higher cost drug promoted by the coupon. We oppose amendments 177 and 336 that would repeal the current prohibition on the use of prescription drug coupons and rebates, undermining current efforts to control health care costs.