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A Healthy Blog

Massachusetts health care – wonky with a dose of reality

April 30, 2005

The National Academy of State Health Policy observes that for 25 years states have served as laboratories for health care reform efforts. In examining the impact and effectiveness of state funded health insurance programs they observe:

"State demonstrations have shown that, in order to provide coverage to significant numbers of the uninsured in a voluntary market, benefits must be comprehensive and affordable, carefully marketed, and offered through a simplified, accessible, eligibility process. They have also demonstrate that the cost of coverage poses a significant barrier to accessing coverage. To achieve affordability, plans must be offered to low-income families with premiums not to exceed one percent to three percent of family income."

If the outcome vision of the three major health care bills being considered in the state legislature is to decrease the numbers of uninsured , they need to learn from the research of NASHP. As these plans develope, it is crucial to design them so they are truly affordable for lower-income families.

This was taken from an op-ed column written by HCFA Board President Chip Joffe-Halpern in the April 28th edition of the North Adams Transcript. To view the entire piece, click here.

April 29, 2005

Last night, both houses of Congress voted along partisan lines to cut $10 billion in Medicaid spending nationally over the next five years as part of the FY06 budget resolution. This same budget plan cuts taxes on everyone making more than $1 million annually by $32 billion. Rarely has the connection been so clear between the needs of working and lower income Americans versus the wealthy.

Sen. Dick Durbin, last night on C-SPAN, recalled last week's event in Illinois to dedicate the new Lincoln Library, an event attended by President Bush. On the roadway to the event, the Senator recalled, one bystander held a sign President Bush could not have missed. The sign asked: "Whose taxes would Jesus cut?" We might add ... and whose health care benefits would Jesus cut?

April 28, 2005

A great new Robert Wood Johnson study provides state by state estimates on numbers of uninsured adults and uninsured adults with jobs. Among uninsured adults, best states were Minnesota (8.3%), Hawaii (9.8% -- love that employer mandate!), and Deleware (10.2%). Worst states -- Texas (30.7% -- helloooo Mr. President), Louisiana, 26.4%) and New Mexico (26%). Uninsured among adults with jobs -- same order, but look -- MN 6.9, HW 8.5, NM 22.6, LA 22.6, TX 26.6. Across the board, more than 80 percent of uninsured, state by state, are folks who work every day and pay taxes.

And how do we do in Massachusetts? We have the 4th best rate of uninsured adults at 11.2%, ditto for uninsured adults with jobs, 10.3%. Here's some data to chew on... uninsured whites in Massachusetts, 8.5%; uninsured blacks, 20.8%, and uninsured Hispanics, 32.8%.

Quick followup notes:

The Mass. House may be wrapping up its budget debate as early as today. Thus far, news for health care access has not been encouraging. Hospital leaders are distracted trying to restore $120 million in cuts to the Free Care Pool, and there's a dearth of money and political will to address access needs thus far. If you haven't done so, please visit our site to send an email to your legislator.

In Tennessee, Gov. Bredesen is now proposing to cut 226,000 from TennCare instead of 323,000. All enrollees would be limited to five prescriptions per month, only two of which could be brand name.

Meanwhile, health reform talk in Vermont is boiling. The House passed a plan last week 86 to 58 calling for a state run health insurance program by 2007, with an assured veto from the governor. The Senate is working on a plan that could attract some Republican support, and is proposing a 3% payroll tax on employers who don't cover their workers. Check out recent coverage by clicking here.

April 26, 2005

Just about a year ago, HCFA's Consumer Helpline began answering online requests for assistance. If you know anyone in need of free advice about their health coverage options, feel welcome to refer them to our Helpline -- phone or email. Meanwhile, here is a small sample of email requests for help our great HelpLine counselors answer every day:

"I am 64 and work full time but have no insurance. Company I work for does not offer it. According to MassHealth, I do not quality for their coverage."

"I am a Home Health Care Aide. We have insurance but it is too high for us girls. They want $75 a week and we only clear about $300 every two weeks. The state places to go to are filled up or a 4 month waiting list. I am on HTC for high blood pressurre and have had to cut back on medication because I can't afford it, and I haven't been to a doctor in over a year. We need your help."

"I work two part time jobs which equals to 40 hours a week. I do not qualify for insurance at one because I don't work enough hours. I do qualify at my other job but they take $150 our of EVERY paycheck which is biweekly. That is more than I can afford. I recently had to spend the night in the hospital and now I have significant medical bills as a result. While I qualify for partial free care, I am one of those people who doesn't make enough to get insurance but makes too much to qualify for state help."

"Currently I have a condition that the doctors can't diagnose without an ultrasound, but the cost to me and my family would be prohibitive. The urologist guessed the condition would resolve itself (though he wanted the ultrasound to make sure). I didn't schedule one because of the costs involved, so I've waited two months. The condition hasn't improved so I really need an ultrasound and a correct diagnosis. I simply can't obtain this procedure without assistance."

"Married senior citizens with combined income of $2400/month. We are paying 1/3 of our gross income for supplemental health insurance...are we eligible for help?"

"My employer is deducting health insurance from my paycheck every week. I have not had health insurance for seven months. I keep asking my employer and he has a different story every month. I am 57. What are my options?"

And what are our options to fix this immoral and inhumane system that places individuals and families in these circumstances? At HCFA, we're doing our best -- check out our Reform home page. Please get involved today!

April 25, 2005

Beginning today, the Mass. House of Representatives begins its annual budget debate. It usually goes on for most of the week, and the key decisions on health issue occur later in the week. HCFA and our allies are working on amendments to fix important health access programs, and we would appreciate your help. Go to our homepage and click to send an instant email message to your state representative.

Our issues include: removing enrollment caps from programs such as MassHealth Essential and CommonHealth, restoring adult dental services, restoring coverage for legal immigrants, and much more. And thanks...

April 23, 2005

At HCFA, we regularly get daily doses of reality. Here are two recent examples:

"I currently have no health insurance, its a god dam ripoff. Been paying $4000 a year for $5000 deductable. No claims for ten years, just $40,000 out the window. Finally had a $6000 operation, they agreed to pay 80% of costs minus $5000 deductable. So they paid nothing, and billed me another $4000 for another year with worse deductable. Out $10,000 for the year and they pay nothing? Screw them. I've switched my health plan to Dr. Kavorkian's jail house phone number outside Detroit. He'll tell me what kind of anti-freeze to drink when the bad one comes, and a lot cheaper than those 3-martini health insurance execs. Health insurance should have nothing to do with employment or employers. Its dragging down hiring and profits. Everyone is in and out of jobs or unemployed."

And here's a brief case synopsis from our HelpLine director, Michele Lee:

"I spoke with a woman who has been caretaker for her now adult disabled son. She just lost MassHealth because social security puts her over-income. She has cataracts and has lost sight in one eye. Now that she can’t see the doctor who has been treating her, she fears the state will find her unfit to care for her son and separate them. It is unlikely this will happen, but that’s her fear and nothing I say can allay it. HLA has put her case on the docket; we’re hoping for a mini-miracle."

April 21, 2005

Today, the Affordable Care Today! Coalition (formerly the Massachusetts Heatlh Reform Coalition) released a poll conducted by respected pollster Tom Kiley on attitudes of Massachusetts voters toward health reform. See the results by clicking here. Among the key results, health care has moved from the third most important issue in the public's mind in November 2003 to the first ranked issue in March 2005. While voters are not favorably disposed toward most tax increases, they support increased tobacco taxes and assessing employers who don't provide health coverage to their workers. As we all know, public attitudes can be fickle, and one poll is only one poll. Still, there has been remarkable consistency since the late 1980s on the issue of employer responsibility to cover their workers -- between 2/3 and 3/4 of the public agrees.

April 20, 2005

Today's Boston Globe reports new Massachusetts data on infant mortality. "In 2003, the year covered in the report presented by the state Department of Public Health, 4.1 of every 1,000 white, non-Hispanic infants born in Massachusetts died before reaching their first birthday compared with 12.7 of every 1,000 black, non-Hispanic infants. The comparable figure for Hispanic infants was 5.6, and for Asian babies 2.7." Check out the full story by clicking here. Since mid-1990s, with fits and starts, African American infant mortality has been trending in the wrong direction. Perhaps tied with life expectancy, there is no more important measure of a society's health than infant mortality.

This is one reason why the Special Legislation Commission on Racial and Ethnic Health Disparities' work is so important. The Commission, which began work late last year, will release a report this coming November providing details on the state of our state's health disparities. For info on the Commission, click here.

April 19, 2005

Our sister organization, Community Catalyst, has collaborated with other organizations to create a great new and free website of information, analysis, and materials to help in the fight to protect Medicaid from cuts by Congress. The site is called "Medicaid Matters," and it's full of useful resources usable anywhere in the nation. Other sponsors include FamiliesUSA, the Center on Budget and Policy Priorities, Neighborhood Health Plan, and others.

The fight to protect Medicaid in the Congressional budget process is happening right now. See our April 14 entry for recent details. Because of the letter signed by 43 House Republicans and sent last week to House budget leaders, there are now clear majorities in the Senate and House on record against the $15 billion in cuts aimed at Medicaid. This fight is far from over. "Medicaid Matters" is your best toolkit to get involved.

April 18, 2005

Beginning next Monday, the Mass. House of Reps will begin debating the FY06 state budget. The House budget writers left out a lot of important items to help uninsured folks get coverage and to help folks already on MassHealth get needed services such as adult dental care. You can send an email message to your state rep and senator today in less than two minutes by clicking here. The debate will last until the end of next week so you have lots of time to give less than two minutes -- please pass the link on to others.
President Bush and Republican leaders in Congress want us to believe that “health savings accounts” are the answer to the problem of uninsurance and health costs. These policies, aggressively marketed across the nation, include high deductibles of at least $1000 for individuals and $2000 for families, combined with a $500 personal savings account that can be rolled over from year to year. HSAs were established by Congress in the 2003 Medicare Modernizatin Act.

We consider the trend toward “consumer driven” health care policies a scam, designed to lure unsuspecting consumers into products that provide fewer benefits with higher cost sharing – with no regard to ability to pay.

Now the Congressional Research Service, in a new report, concludes HSAs will reduce utilization by stopping policy holders from seeking medically necessary care, and they are not likely to cut the number of uninsured or reduce health care spending, in an April 14th report. "It would be unreasonable to expect them to produce a significant reduction in the nation's health care costs," the report stated. Five percent of individuals account for about 50 percent of health care costs, and 20 percent account for 80 percent, the report said. "HSA plans with their relatively low out-of-pocket maximums will have little impact in reducing the health care spending for these groups," CRS said.

Some question whether it is fair that the biggest tax savings under HSAs "will likely flow to healthy, higher income taxpayers," the report said. "Some might also question whether the revenue loss is an appropriate use of federal health care resources, given the many people in the country who have no health insurance whatsoever."