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A Healthy Blog

Massachusetts health care – wonky with a dose of reality

January 23, 2020

The Massachusetts Health Connector Open Enrollment period officially closes on January 23, 2020. However, this does not mean enrollment is “closed” for everyone. The Open Enrollment period is the annual time for Health Connector members to change their plan for any reason, and for new applicants to shop for health insurance without a “qualifying life event.”

So what happens on Health Care For All’s HelpLine and with all the enrollment assisters across the state on January 24th? The answer is (drum roll, please): a lot. Consumer assistance programs that help people enroll into health insurance are not limited to aiding people with their applications during the Open Enrollment period. They do so much more. Enrollment assisters continue to be busy post-Open Enrollment because many people can apply for health insurance after that day, or because they may experience life changes that require updating their coverage. People who qualify for MassHealth, the Health Safety Net, Children’s Medical Security Plan and people who would be newly determined eligible for ConnectorCare, can apply at any time throughout the year. Other people may be eligible for what is known as a Special Enrollment Period. This allows them to go through the Health Connector to shop for private insurance if they experience qualifying life events such as moving, employment or income changes, marriage, divorce, birth, change in household dependents, and loss of health insurance. Also, if an individual is member of a federally recognized tribe or Alaska Native shareholder, they are able to apply for health insurance at any time.

On December 9, 2019, The Boston Globe published a piece that I wrote about what it is like to work on the HelpLine and the importance of consumer assistance. This piece paints a picture of the broad range of issues handled on the HelpLine throughout the year.

The HelpLine troubleshoots health insurance issues that can happen at any point in the year in English, Spanish and Portuguese. HelpLine counselors regularly make conference calls with clients and MassHealth or the Health Connector to diagnose problems and resolve coverage issues. Those calls do not stop once enrollment is completed. Callers want to know how to use their coverage, how to understand the out of pockets costs associated with their plan, and if they can get any other assistance with their health care expenses. In addition, people already on coverage need help updating their applications through the Health Connector and MassHealth throughout the year when they experience a change.

Successful consumer assistance is provided by community organizations understanding how to reach the communities they work with, and providing culturally competent aid in the languages most spoken in the area(s) they serve. Consumer assistance for health insurance is needed year round and this important work should get the financial support that it requires and deserves. Health Care For All is advocating for additional funding for programs like the HCFA HelpLine to continue the crucial work being done day in and day out. Consumer assistance is pivotal in keeping Massachusetts as the #1 in coverage rates, and making sure consumers have access to affordable health care when they need it. 

- Hannah Frigand, Director, Education and Enrollment Services at Health Care For All

January 23, 2020

Last week, the Protecting Immigrant Families (PIF) campaign released the report, Navigating Public Charge: Best Practices in Community Based Organizations to Mitigate the Harm for the Immigrant Community, a compilation of the best practices for community based organizations (CBOs) to reduce the risk posed by the current environment to immigrant communities. The results were gathered in collaboration with immigrant-serving organizations from across the country, who contributed their experiences and expertise to provide insight for the report. Health Care For All was one of the twenty-seven advocacy and immigrant-serving agencies who were acknowledged in the document.

The report serves as a roadmap for CBOs, narrowing down the most effective approaches to support immigrant communities. Some of these practices include: building coalitions to oppose changes to the “public charge” rule and develop education and outreach strategies, offering trainings that are culturally sensitive, and incorporating feedback and leadership to and from the community. The report also emphasizes the importance of coordination with legal support and points out that education funds can be utilized to inform immigrant communities and their leaders about public charge.

HCFA shared some of the key strategies implemented in Massachusetts to address the fear and uncertainty impacting immigrant communities. One of the immigration policies coming from the federal administration that is causing great concern is the new “public charge” rule. This is an attempt to broaden the factors taken into account to determine if an immigrant applying for a green card is a public charge. Being deemed a public charge may prevent them from adjusting their immigration status. That’s why many organizations such as HCFA have focused their efforts on educating the community on the rule and what it means for them.

Maria R. González Albuixech, Director of Communications and Immigrant Health at HCFA, is quoted in the report discussing several tactics implemented in the Commonwealth. One of the strategies highlighted is the combination of Affordable Care Act (ACA) enrollment efforts with education about public charge, immigration, and use of benefits in general: “We brought 4-5 pro bono immigration lawyers and enrollment assisters to the same event. We could advise on public charge at the same time.” At such events, HCFA and partners do not only help people apply for health insurance, but also provide answers to their immigration questions and dispel concerns regarding the use of benefits they are entitled to. “Health Care For All Massachusetts monitored ACA health insurance enrollment numbers after a significant outreach campaign targeting the immigrant community and including public charge education. Their intention to reduce the impact of public charge fears on ACA enrollment is measured by the overall enrollment rates in the immigrant community.”

One of the biggest challenges to address the “chilling effect” that’s preventing immigrant communities from living productive and healthy lives under current circumstances is the lack of financial support for this specific line of work. A strategy suggested in the report is reframing ongoing work to bridge that gap: “Groups involved in ACA enrollment such as Health Care For All Massachusetts were able to secure funding from their state’s health insurance exchange to share public charge information as part of enrollment education.”

Through a collection and evaluation of the strategies implemented by organizations throughout the country to support immigrant communities, this report identifies the best path forward for CBOs so that they can provide effective assistance to immigrants who need to navigate public charge to develop long-term success.

If you would like to read more, you may access the links for the full report and executive summary.

- Jill Makin, Communications and Policy co-op at Health Care For All

December 11, 2019

Massachusetts continues to lead in children’s access to health care, however, many children and families continue to face barriers to coverage and care. Families, advocates, and policymakers recognize the need for additional improvements to ensure that all residents of the Commonwealth – particularly children and youth – can access the care they need. With this concern in mind, on July 29th Massachusetts Speaker Robert DeLeo introduced a bill known as An Act relative to children’s health and wellness (H. 4012). The bill included several policy proposals, two of which are Children’s Health Access Coalition (CHAC) priorities: ensuring continuous MassHealth coverage for former foster youth and requiring the Health Policy Commission (HPC) to study access to care for children with medical complexity, as well as a Health Care For All (HCFA) and Children’s Mental Health Campaign (CMHC) priority: improving the accuracy of provider directories, which the Senate had previously passed as stand-alone legislation this spring (S. 2295).

The Senate then introduced and passed their version of the legislation that included some variations on the provisions included in the House bill, along with several additional provisions related to the Department of Children and Families and other issues (S. 2368). A Conference Committee quickly worked out the differences and by November 20th, the legislature enacted the new version of the bill, H. 4210. Governor Baker signed the final version of An Act relative to children’s health and wellness on November 26th, making it a law in Massachusetts – Chapter 124 of the Acts of 2019.

This new law will have a positive impact on children, families, and individuals in communities across Massachusetts. Chapter 124 includes provisions similar to legislation filed by Representative Barber and Senator Lewis (H. 913/S. 610) to improve the accuracy of health insurance provider directories. Families and individuals seeking care in Massachusetts often face difficulties finding providers through their health plan’s provider directory because insurers may not regularly update their provider directories. As a result, insurance carriers appear to have adequate networks, however, upon closer inspection, a number of listed providers have moved, closed their practice, or no longer participate in a given plan – “ghost networks.” Even for providers who are still practicing and in-network, the provider directory often contains inaccurate information about the services they deliver, languages providers speak, and whether or not the provider is accepting new patients. These issues are particularly acute for families seeking behavioral health care. Chapter 124 would make short-term improvements to provider directories, including ensuring that provider directories are easily searchable, available to the public, and updated at least monthly, as well as establish a taskforce, chaired by the Division of Insurance, to make recommendations and develop regulations to make further improvements to provider directories. These provisions reflect the language agreed upon by advocates, health insurance carriers, and providers.

For some populations, the bill already had an impact even before being enacted by the legislature and signed into law. The Affordable Care Act included a provision to require states to provide Medicaid coverage to former foster youth until the age of 26, given that they were in foster care as of the age of 18, just like other young adults who are allowed to remain on their parent’s insurance until that age. However, given extensive challenges and the transient nature of former foster youth, many young adults who had “aged out” of care through the Department of Children and Families lost their MassHealth coverage for a period of time. Eligibility redetermination paperwork is sent to their last known address, at which these young adults may no longer reside causing delays or loss of coverage. If received, much of the form required them to fill out information on their income, despite being eligible for coverage under federal law regardless of income. The language included in Chapter 124 was based on legislative filed by Representative Gregoire and Senator DiDomenico requiring MassHealth to create a simplified redetermination process for former foster youth (H. 124/S. 35). In addition to the legislature, advocates are working with MassHealth to take steps to ensure uninterrupted coverage for former foster youth. Former foster youth between the ages of 18 and 26 will find it easier to maintain their MassHealth coverage by the end of 2019, due to a new system staff and leadership at MassHealth is putting into place to ensure continuous coverage for this population. The new system will protect MassHealth coverage for this population until their 26th birthday without the need to complete redetermination paperwork. This is a big step forward for former foster youth and again puts Massachusetts on the map as a leader in access to health coverage.

December 2, 2019

Massachusetts is known for its dedication to expanding access to health care, especially for the most vulnerable populations, including children. As a state, Massachusetts has led the cause by developing health coverage systems which were used as models for the Children’s Health Insurance Program (CHIP) and the Affordable Care Act (ACA). The Georgetown University Health Policy Institute Center for Children and Families (Georgetown CCF) recently released their annual report about the child uninsurance rate. This year’s report, The Number of Uninsured Children is On the Rise, compares health insurance data from the US Census Bureau’s American Community Survey from 2016 through 2018.

While children’s health coverage rates had been improving for many years prior to 2014, due in large part to the creation of programs like CHIP, the ACA further decreased the rates and number of children without insurance to their lowest levels in 2016. These programs allowed for an increase in coverage eligibility and simplification in the enrollment process. However, since 2016, children’s participation rates in Medicaid and CHIP have decreased for the first time since 2008, when participation began to be measured.

Although the state continues to lead with the lowest uninsured rate for children in the US, the uninsurance rate for the Commonwealth’s children increased by 0.2%, comparing 2016 and 2018. Our blog post on last year’s Georgetown CCF report on uninsured children highlights an increase in the child uninsurance rate even in Massachusetts – from 1% to 1.5% from 2016 to 2017. Looking at this year’s report, it appears the uninsurance rate for children in the state has actually decreased from 1.5% to 1.2% between 2017 to 2018. However, compared to 2016, the actual number of uninsured children continues to be slightly higher.

To put this in context, Massachusetts continues to lead the nation in health coverage for children. The Georgetown CCF report highlights other states where state and federal policy decisions have led to an increase in uninsured children, with no progress in moving the needle in this respect. Almost half (49.6%) of uninsured children in the US reside in just six states – Texas, Florida, California, Georgia, Arizona, and Ohio. Of these states, Texas, Florida, and Georgia have not expanded Medicaid for parents or childless adults, and there are still several other states that are “holdouts” in this regard – which can impact health coverage for children as well. The report shows one state – North Dakota – has made some progress in decreasing the child uninsurance rate.

Many factors can lead to the continued downward trend of health coverage for children during the past couple of years. The report cites the decrease in public health coverage as a major factor in the increase in uninsured children. Current federal policymakers have had a different approach when it comes to access to care. Attempts from Congress to repeal the ACA and the administration in chipping away at certain ACA protections, the repeal of the individual mandate penalty in 2017 and funding cuts for ACA outreach and enrollment have all brought a reduction in infrastructure and focus on ensuring enrollment in health coverage. Even the delayed budget extension for CHIP led to confusion among families who rely on the program about whether the benefits would continue. Researchers at Georgetown CCF believe that the increase in negative immigration rhetoric and policies on the federal level have also deterred families from enrolling their children in public benefits, including health insurance, such as parents disenrolling their eligible children despite their legal immigration status.

In Massachusetts, Health Care For All and stakeholders in the health care community are dedicated to protecting and improving access to health coverage. We also know that having health insurance does not necessarily translate into having access to care. Some health insurance comes with high costs and some safety-net programs, even for children, have caps on services and leave gaps in coverage of necessary care. That is why HCFA and the Children’s Health Access Coalition is advocating for a bill which would ensure that low-income immigrant children in our state have equitable access to coverage. An act to ensure equitable health coverage for children (H. 162/ S. 677) better known as Cover All Kids, seeks to expand comprehensive MassHealth coverage to low-income children who would otherwise be eligible except for their immigration status. This bill would help more than 30,000 children and young people in our state obtain the coverage they need, to live, learn, and thrive. If your child or the children you serve are facing barriers to accessing because they depend on the Children’s Medical Security Plan (CMSP), MassHealth Limited, or the Health Safety Net (HSN), share your story today and together we can a difference! Now is the time for Massachusetts to Cover All Kids.

August 22, 2019

The Blue Cross Blue Shield of Massachusetts Foundation has released a new report on uninsurance rates across the state, The Geography of Uninsurance in Massachusetts: An Update For 2013-2017. The report is based on the five years of data from the census’ American Community Survey (ACS), which surveys 2 million households annually to identify uninsured residents. Here is a basic rundown of the findings of their research and what you need to know! If you’re interested, you can find the full report here.

The uninsurance rate across the state varies drastically but there are some clear trends. Communities in more urban areas, like the Boston region, have the highest uninsurance rates. However, in wealthier and more suburban communities, like those in the MetroWest Region, the uninsurance rate is the lowest in the state. Below, you can see the top 10 communities in both uninsurance rate and number of uninsured.

Health Care For All’s HelpLine provides multilingual and culturally competent direct services to improve access to health insurance and care for underserved communities such as the ones listed in the table.

The residents in these communities are generally from similar demographics. A little bit less than half of these residents are noncitizens and about one-quarter of the families have incomes below the federal poverty line. Residents from the most uninsured communities face barriers to receiving consistent coverage because of these disadvantages. In the map below, the red shows communities with the most uninsured residents and the beige show communities with the fewest. The biggest concentration of uninsured residents comes in and around the Boston area.

If you know someone who is uninsured or needs help navigating the complicated healthcare system, please connect them to HCFA’s HelpLine at 1-800-272-4232.

May 23, 2019

Last Saturday, Health Care For All (HCFA), in partnership with the Massachusetts Immigrant and Refugee Advocacy Coalition (MIRA), the Massachusetts Law Reform Institute (MLRI) and Health Law Advocates (HLA), implemented a training under the title “Democracy School 2019: Building Health Care Power in Immigrant Communities”. Even though it was a beautiful day in Boston, 35 people - including advocates, community leaders and members, immigration and medical providers - chose to spend their Saturday attending the session and learning more about the struggles our immigrant communities face to live productive and healthy lives in the current environment. 

This session was part of a coordinated, ongoing effort to inform immigrants and the groups that serve them about their health care rights. It also aimed to dispel the growing fear and mistrust within immigrant communities that is preventing many individuals and families from seeking the health care services they need - when they need them.

The training went over important topics that combine immigration and health care such as: immigrants’ health care rights, the state of immigrants in Massachusetts and state efforts to protect them, immigrant eligibility for health insurance, how to apply for health insurance, understanding the proposed rule on “pubic charge” and other potentially damaging policies impacting immigrants’ use of benefits, and how to access and navigate the immigrant health toolkit. The evaluations were very positive, participants were very engaged and had interesting questions regarding the topics laid out.Thank you Liza Ryan (MIRA), Vicky Pulos (MLRI), Justin Lowe (HLA), 

HCFA is committed to ensure that all participants have access to the resources they need to provide accurate information to our immigrant communities regarding their health care rights. Many of the attendees submitted written questions that we are currently working on getting appropriate answers for. We will upload all the documents - presentations, fact sheets and Q&As - on the immigrant health toolkit on https://www.hcfama.org/immigrant-health  in the next weeks. Feel free to reach out to Rosana Gijsen at rgijsen@hcfama.org if you have more inquiries that were not addressed during the session or if you want to get involved in the Immigrant Health Care Access Project (IHAP).  

 

May 21, 2019

MassHealth – the state’s combined Medicaid and Children’s Health Insurance Program (CHIP) – is a cornerstone of the Massachusetts health coverage system, providing coverage of medical, behavioral health and community-based services for 1.8 million low-income Massachusetts residents. MassHealth enrollees are often characterized by a narrow set of baseline statistics; however, MassHealth enrollees represent a diverse range of life experiences and health care needs.

MassHealth serves our most vulnerable residents across their life spans from infants and children with special needs who gain access to comprehensive health care and support services required to reach their full potential, to the elderly and those living with disabilities who receive community-based care that helps them remain in their home. MassHealth provides health insurance to more than 1 in 4 Massachusetts residents, including: more than half of the population with disabilities; more than 40% of all children; and 3 out of 5 people in low-income families.

Health Care For All is proud to partner with Manatt Health and the Blue Cross Blue Shield of Massachusetts (BCBSMA) Foundation on a new publication, Faces of MassHealth: Portrait of a Diverse Population. This detailed set of data and narrative profiles of MassHealth enrollees illustrate the different life circumstances that lead people to MassHealth, and the various ways that MassHealth touches their lives.

Key findings from the quantitative portion of this project include:

  • The geographic distribution of MassHealth members mirrors that of the Commonwealth’s population.
  • The vast majority of MassHealth enrollees have very low incomes, well below the poverty level.
  • Women account for more than half of all adults and nearly two-thirds of seniors enrolled in MassHealth.
  • Unstable housing is a problem for more than 1 in 10 MassHealth enrollees.
  • Children, seniors and people with disabilities make up 60% of the MassHealth population.
  • While most MassHealth enrollees speak English as their primary language, a substantial minority do not.
  • The MassHealth population is racially and ethnically diverse, but more than 6 in 10 enrollees self-identify as white.

In addition to the quantitative analysis, the qualitative portion of the report includes five journalistic profiles of MassHealth enrollees. Health Care For All extends gratitude to Jessica, Anne, Kristal and Sal, Angela and Massimo, and Amy, for sharing their stories, which made this project possible. Special thanks go to Natalie Litton, Health Care For All’s former Policy and Policy Coordinator, who led this section of the project, undertaking extensive outreach efforts, conducting interviews, and writing the five journalistic profiles contained in the report.

We hope this report will help policymakers and other stakeholders better understand the breadth and diversity of the individuals and families across the Commonwealth who rely on MassHealth coverage in order to access the health care they need. Faces of MassHealth points to the critical work of protecting and sustaining the MassHealth program over the long term, to ensure that the program is available to Massachusetts residents from all walks of life who need it.

May 15, 2019
Prescription drug prices continue to rise, placing a considerable burden on families and the state's budget. Over the past five years, prescription drug spending has nearly doubled in MassHealth, twice the rate of other spending in the program.
 
The Senate Ways and Means Committee recently included strong language in their proposed FY20 budget that would give MassHealth critical new tools to negotiate lower prices for unreasonably priced drugs.
 
Senator Boncore has filed an amendment that would significantly weaken this provision. Amendment #654 would keep drug price negotiations behind closed doors and prevent MassHealth from being able to hold drug manufacturers accountable.
 
Drug manufacturers should be able to make a profit on their life-saving products, but patients and the state should understand how much these drugs cost and be able to negotiate a fair price. Drugs only work if people can afford to buy them.
 
Beginning next week, the Senate will hold its budget debate. Please call or email your Senator this week to urge them to oppose Amendment #654 and maintain their commitment to address rapidly rising drug costs.
 
Find out who your Senator is and their contact information hereand you can use the email and call scripts below. 
 
We appreciate you taking action on this critical issue to address high drug costs in the MassHealth program. Please contact Yaminah Romulus at yromulus@hcfama.org or 617-275-2935 if you have questions about how to oppose this amendment.
 
Thank you,
Yaminah 
 
Phone Script Opposing Amendment #654:
 
Hi, my name is ______.
 
May 9, 2019

Just as the mouth is part of the body, oral health is a part of overall health. People cannot be healthy unless they have access to the dental services they need.When dental disease is left untreated it can lead to systemic infection, hospitalization, and the worsening of other medical conditions. For years, Health Care For All has worked on issues related to oral health, including public awareness about the importance of oral health, and access to comprehensive dental care for everyone.

 

Last Tuesday, HCFA and our allies in the Oral Health Advocacy Taskforce took to Beacon Hill to testify before the Joint Committee on Public Health in support of An Act to Improve Oral Health For All Massachusetts Residents (S.1215/H.1916) legislation that authorizes an additional dental professional, called the dental therapist, to work with a dentist to provide oral health care to more people. HCFA also testified on behalf of An Act Relative to the Restoration of MassHealth Adult Dental Benefits (S. 1212/H. 1917) A bill that will restore full MassHealth dental benefits to more than 1 million individuals, including over 113,000 seniors and 230,000 people living with disabilities. HCFA also provided key testimony to the committee in support of An Act to Promote Public Health Through the Prevention and Wellness Trust Fund (S. 1293/H. 2012) This bill would maintain the solvency of the Prevention and Wellness Trust Fund (PWTF) which funded successful clinical-community partnerships focused on childhood asthma, falls among older adults, hypertension, and tobacco use.

 

The room at the hearing was packed on Tuesday. A wide range of stakeholders, including: The Better Oral Health in Massachusetts Coalition, the MassLeague of Community Health Centers, the Mass Dental Hygienists Association, the Forsyth Institute, Massachusetts Senior Action Council, Rosie’s Place, and the ARC of Massachusetts, to name a few, testified in support of the two oral health bills.

HCFA’s Oral Health Program Director, Dr. Neetu Singh, led the charge in providing expert testimony for both bills. Dr Singh made the case that restoring full MassHealth adult dental benefits would not only benefit the Commonwealth’s oral health, but the state’s financial health as well, pointing out that patients who have to skip the dentist’s office are far more likely to end up in the emergency room. Dr. Singh shared research showing that MassHealth members disproportionately use the Emergency Department (ED) for preventable oral health conditions at a cost 4-7 times that of a community-based dental office visit. In just one year, there were over 36,000 preventable oral health ED visits in Massachusetts, costing the health care system between $15 million and $36 million.

April 12, 2019

Prescription drugs don’t work if people can’t afford them, and too many people in Massachusetts can’t afford the high cost of prescription drugs. Here at Health Care For All (HCFA), we know all too well – from real-life stories and statistical data alike – that this is true. That’s why HCFA is a leading member of the MA Prescription Drug Affordability Coalition, a broad-based coalition representing a wide range of stakeholders, including consumer advocates, seniors, children, individuals with disabilities, providers, provider groups, unions, faith-based groups, mental health organizations and health policy experts.

Yesterday marked a significant milestone in our fight to reduce prescription drug costs as we headed to the State House to testify before the Joint Committee on Health Care Financing, chaired by Senator Cindy Freidman and Representative Jennifer Benson. HCFA submitted both written and oral testimony in support of An Act to Ensure Prescription Drug Cost Transparency and Affordabilty (H.1133 / S.706), sponsored by Senator Jason Lewis and Representative Christine Barber. The legislation aims to make prescription drugs more affordable and available to consumers, make pharmaceutical costs more transparent, and contain costs for MassHealth, employers, and across the health care system.

The hearing room was packed as individuals and groups on both sides of the debate converged to testify on this and other bills related to prescription drug costs. Mary Mack came all the way from Nantucket to share her story as someone who lives with advanced heart failure and muscular dystrophy as the result of a genetic defect. When she started a new cardiac drug, it made “a significant difference” in her life. At $150, however, the copay was the equivalence of a car payment or a trip to the grocery store to feed her family. In order to afford the copay, she was forced to neglect other doctors appointments, accrue credit card debt and fall behind on bills. When the copay increased even more, Mary had to stop taking the drug in order to meet her car payments. Now that Mary has paid off her car, she is taking the medication again, but in order to afford the monthly $225 copay, Mary and her family must make other sacrifices.

Panels included consumers who have struggled with the cost of insulin to treat their Diabetes, seniors and representatives from Health Law Advocates, the Massachusetts Medical Society, MASSPIRG, 1199SEIU, the Disability Policy Consortium, the Greater Boston Interfaith Organization, and AARP-MA.

HCFA Executive Director Amy Rosenthal drew on the stories of callers to our consumer HelpLine as she emphasized the importance of a crucial element of this legislation: giving state regulators the authority to set an Upper Payment Limit (UPL) on prescription drugs deemed unreasonably expensive. This would create an upper limit on what anyone, including doctors, pharmacies, insurers and patients, could be required to pay for a drug. Amy also placed the fight for increased transparency and lower costs in the broader context of health care access. “Health reform worked because of shared responsibility among the state, consumers, employers, payers and providers.” Of the current efforts, she said, “It’s time for the pharmaceutical industry to step up.”

Chairwoman Cindy Freidman seemed to agree. "You all have had a long time to be transparent," she told Bob Coughlin, president and CEO of MassBio, a pharmaceutical industry trade organization. "Pharmaceutical companies have had a long time to come to the table and say let us be as transparent as our insurance companies are and as all the other parts of health care that we patrol. You have had that opportunity, and you haven't done it. With all due respect, we want you at the table but we need you to be equal partners and be willing to understand that you have skin in the game, we have skin in the game, everybody in this room does."

Multiple panels featured the testimony of those who have the most “skin in the game” – Massachusetts consumers who, for too long, have been forced to make unfair decisions between the necessities of life and the prescription drugs their lives often depend on. HCFA and the MA Prescription Drug Affordability Coalition invite you to join our fight for #AffordableRxNow. This is just the beginning.

-Natalie Litton

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