A Healthy Blog

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

Senate Unveils Budget

Senate Unveils Budget

May 20, 2010

The Senate Ways and Means proposed budget was released on Wednesday. You can read the bill and Committee supporting materials; as always, the instant analysis from the Mass Budget & Policy Center best summarizes the proposal; and here's our statement.

Not much has changed since the House budget was debated in late April. Massachusetts is still recovering from the recession and revenues are still below needs. Funding for agencies and departments, including local aid, have been cut. Senate Ways and Means Chairman, Senator Panagiotakos, released a $27.88 billion budget that adds $53 million to what the House voted on. The SWM budget does not include any new revenues, including the HCFA-supported removal of the sales tax exemption on non-nutritional food and beverages and the closing of the chewing tobacco loophole in the cigarette tax. The lack of new revenues is in part why the SWM bottom line is $330 million below what the Governor proposed in January.

The Committee had to make many difficult decisions. However, the SWM has some investments in creative health programs that will save the Commonwealth money in the future. Our appreciation goes to Chairman Panagiotakos, Speaker Murray and Senator Moore for their continued commitment to health reform and payment reform and finding ways to cut cost in the health care delivery system while improving health care quality.

Among the innovative programs that the SWM proposes is $93,000 for DPH’s academic detailing program. Academic detailing is the evidence-based prescription drug outreach and education program that takes information learned through comparative effectiveness research on drugs and translates it into practice for health care practitioners. By using the tactics of pharma marketing, but providing objective information, the program generates better care and cost savings. Additionally, SWM included $2.5 million to support the enrollment and outreach grants funded through the Connector (Section 139). SWM also proposed implementing two initiatives in MassHealth to better manage chronic disease. Section 123 calls for a chronic disease management program. Another proposal, also added by amendment to the House budget, sets up a pilot global payment program for coordinated care for high-risk pediatric asthma patients enrolled in the MassHealth program, designed to prevent unnecessary hospital admissions and emergency room utilization (Section 138).

Many of HCFA’s priorities were funded similar to the House proposal. Funding for programs such as the DPH’s Office of Oral Health, Children and Adolescent Mental Health Consultative Services, Children’s Behavioral Health Initiative, Children’s Medical Security Program, Early Intervention and Health Start are investments for long term cost savings. As Massachusetts becomes a leader in better coordinated care, these programs provide a crucial component of individual’s health coverage. The SWM also granted the division of health care finance policy the ability to assess penalties against private health care payers for failing to meet deadlines for its All-Payer Claims Database (remember APCD?).

HCFA is supporting a number of budget amendments for programs included in the SWM budget that desperately need additional funds. Please call your Senators and ask them to support the following amendments.

  • Outside Section 134 cuts MassHealth adult dental benefits. Senator Chandler will be filing an amendment to preserve full benefits (more information)
  • Outside Section 135 funds the Commonwealth Care Bridge program, the reduced benefits plan for legal immigrants, at $60 million. This amount is insufficient to cover all eligible legal immigrants, and will leave more than 13,000 eligible people without coverage. Senator Chang-Diaz will file an amendment to increase funding for the program to $75 million.
  • Senator Flanagan will be filing an amendment to establish a 12-month continuous eligibility period for children in MassHealth. This would reduce the churning and gaps that needlessly hurt kids' ability to get needed care. A similar amendment passed the House.
  • The Quality Division at DPH has been drastically cut in funding. Senator Fargo will file an amendment to get more funding for the Division and the infection control and prevention program at DPH.

Budget debate set to begin Tuesday, May 25th.
-Mehreen Butt