"Health Care For All" in lights on a bridge

A Healthy Blog

Massachusetts health care – wonky with a dose of reality

January 25, 2017

HCFA worked with a diverse group of legislators in both the House and the Senate to file a broad package of legislation for 2019-2020:

  • Reduce Prescription Drug Costs (H. 1133/S. 706, Representative Barber & Senator Lewis)
    • Prescription drug prices are the leading factor in driving up health care costs across the system, impacting the budgets of individuals, families, employers and the state. An Act to ensure prescription drug cost transparency and affordability will: provide transparency around the underlying costs to produce prescription drugs; restrain abuses of pharmacy benefit managers (PBMs); authorize the Health Policy Commission to set upper payment limits for unreasonably high-priced drugs; require pharmacists to inform consumers if purchasing a drug at the retail price would be cheaper than using insurance; provide tools to strengthen MassHealth’s ability to negotiate lower drug prices; and support a permanent authorization and funding source for “academic detailing” to ensure doctors get accurate information to counter biased drug manufacturer marketing.
  • Limit the wining and dining of doctors by drug marketing sales personnel: (S. 703, Senator Lewis)
    • Research has shown that the provision of meals is effective in influencing a doctor’s prescribing practices. In 2008, HCFA was instrumental in passing a Massachusetts law that limits these promotional efforts to “modest meals.” However, under strong pressure from drug companies and the restaurant industry, the state’s regulatory definitions have loose restrictions on meals and permit alcoholic drinks at these educational programs. An Act to define modest meals and refreshments in prescriber education settings will put reasonable limits on meals and ban all alcohol in these settings.

Children’s Health Access

  • Expand Health Coverage for Children (H. 162/S. 677, Representative D. Rogers & Senator DiDomenico)
    • Currently, low-income immigrant children who are not otherwise eligible for MassHealth can access only very limited health coverage, which leaves them without adequate access to many services, including prescription drugs, mental health services, durable medical equipment, dental services, and emergency care. An Act to ensure equitable health coverage for children would expand MassHealth coverage to low-income children whose only barrier to accessing comprehensive coverage is their immigration status. Other states, including California, Washington, Oregon, Illinois and New York have already enacted this policy.

Dental Care Access

  • Expand Access to Dental Care through Dental Therapists (H. 1916/S. 1215, Representatives Hogan and Pignatelli & Senator Chandler)
    • The most vulnerable populations in Massachusetts often forgo their oral health needs due to the lack of easy access to a dentist. An Act to improve oral health for all Massachusetts residents authorizes an additional dental professional, called the dental therapist (DT), to work with a dentist to provide oral health care to more people. DTs present a critical opportunity for Massachusetts to close gaps in dental access for seniors, low-income families, children, and people with special needs. 
  • Restore Full MassHealth Dental Benefits (H. 1917/S. 1212, Representative Honan & Senator Chandler)
    • An Act relative to the restoration of MassHealth adult dental benefits will restore full MassHealth dental benefits to more than 1 million individuals, including over 113,000 seniors and 230,000 people living with disabilities. Important dental services that are vital for good oral health and saving teeth are not currently covered by MassHealth. Left untreated, dental disease can lead to systemic infection, hospitalization, and the worsening of other medical conditions. Oral health is an integral part of overall health and should be included in health coverage.

Private Health Insurance

January 19, 2017

Make your voice heard by joining hundreds of sexual health advocates from across the state for the Sexual Health Lobby Day at the Massachusetts State House in Boston on Tuesday, January 31, 2017.

Sexual Health Lobby Day is an exciting and meaningful opportunity to meet directly with your elected officials and advocate for access to sexual and reproductive health care.

In today’s uncertain national political climate, we need to ensure that here in Massachusetts sexual and reproductive health care is prioritized, defended, and expanded by our own state legislature. Sign up below!

Please join for some or all of the following activities at the State House in Boston.

Sexual Health Fair: From 9:30 a.m.-10:30 a.m., grab some coffee and meet representatives from the state’s leading sexual health providers and advocacy organizations to learn about opportunities to get involved, take action, and take care of your health.

Raising Our Voices: From 10:30 a.m. – 11:00 a.m., hear from activists who will share their stories and mobilize with us to protect sexual and reproductive health care. Stay tuned for more information about the speaking program!

Lobbying 101: From 11:00 a.m. - 12:00 p.m., come learn what lobbying is and get all the information and practice you need prior to meeting with your elected officials.

Meetings with Legislators: From approximately 12:00 p.m.– 2:00 p.m., join a group of your peers from your legislative district(s) in meetings with your state legislators and let them know sexual health matters to you! You will have the opportunity to speak directly with your elected officials and their staff to advocate for important legislation to  protect and increase access to birth control, comprehensive sex education, and confidential health care.

The State House is in walking distance of the Park Street and Downtown Crossing MBTA stations and parking is available in the nearby Boston Common Garage.

Register for Sexual Health Lobby Day at the Massachusetts State House in Boston on Tuesday, January 31st 2017.

January 19, 2017

Please join Health Care For All, over 120 organizations and over 20,000 individuals at the Boston Women's March on Saturday, January 21st. We will be marching as part of 300 simultaneous, non-partisan, women-led marches happening across the country.

Together, we will send the message to state and national leaders that the United States of America stands for values of human dignity, equal rights and freedom from discrimination. We will focus specifically on showing our support for the Affordable Care Act and the life-saving coverage gains we have made because of the law here in Massachusetts.

 

LOGISTICS: 

PLEASE CONFIRM YOUR ATTENDANCE: Reply to this email and let us know you are coming!

TIME: 10:30am - 3:00pm

MEETING PLACE: Meet at 10:30am at Brewer Fountain located on the Boston Common near the entrance of Park Street Station. (Corner of Tremont and Park Street)

ATTIRE: Please dress warmly and wear comfortable shoes. If possible, please wear Health Care For All colors: Red, White or Blue!

SIGNS: We will be bringing signs to share as well as our large "Health Care For All" banner. Please feel free to bring your own sign, ideally themed around protecting health care and the ACA!

PROGRAM: 11:00am - 12:00pm on Boston Common

PROGRAM LOCATION: "Carty Parade Ground", at the corner of Beacon and Charles Streets.

MARCH: 12:30pm - 2:00pm on a 1 mile route from Boston Common to Commonwealth Avenue, turning at Clarendon and back to the Common.

GATHER: 2:00pm - 3:00pm Boston Common for community building

Learn more about the Boston Women's March here. 

 

Unable to join us on Saturday? Make a donation today to support Health Care For All during this critical time. Your support is what makes our work possible.

 

Thank you and see you on Saturday! 

-The Staff of Health Care For All 

January 12, 2017

Donald Trump and the Republican leadership are marshaling their forces to destroy health care in America. It’s up to us to fight back.

This Sunday, January 15th, a national day of rallies are scheduled to save health care. Senator Elizabeth Warren, along with Senator Edward Markey and members of the Massachusetts congressional delegation, will be hosting a rally at Faneuil Hall with hundreds of people. Join the HCFA contingent!

Send us an email at organizing@hcfama.org

Event will begin at 1:00 PM. Doors open at 12:00 Noon (first come, first served).

Time: Sunday, January 15, 2017 12:00 PM - 3:00 PM EST
Host: Senator Elizabeth Warren, Senator Ed Markey, Mayor Marty Walsh, and members of the MA Congressional Delegation
Location:
Faneuil Hall (Boston, MA)
1 Faneuil Hall Sq
BostonMA 02109
Directions: Please take public transportation if possible. T stations for the Red, Orange, Green and Blue lines are nearby: http://www.mbta.com/
December 8, 2016

It would be a disaster if the ACA were repealed, almost 370,000 Massachusetts residents would lose health coverage in 2019.

Chart from CBPP factsheetThat’s the stark conclusion of an analysis just released by the Urban Institute and the Center on Budget and Policy Priorities (CBPP). The report details the implications of a partial repeal of the Affordable Care Act through “reconciliation” – the process that allows the US Senate to approve budget-related bills with just 51 votes, avoiding a filibuster.  The report concludes that, “This scenario does not just move the country back to the situation before the ACA. It moves the country to a situation with higher uninsurance rates than was the case before the ACA’s reform.”

Here are some highlights from the report:

On the national level:

  • 29.8 million people nationwide would lose health insurance coverage. Of these 29.8 million, a majority of them would be working-class families and minorities.
  • Of the 29.8 million people newly uninsured, 22.5 million would become uninsured because they would no longer be eligible financial assistance.
  • Many, if not most, insurers are unlikely to participate in Marketplaces in 2018—even with tax credits and cost-sharing reductions still in place—if the individual mandate is not enforced starting in 2017.

But what about in Massachusetts? The CBPP looked specifically at the impact here.

  • The number of uninsured people would increase by 273%, to over half a million uninsured.
  • The health care system would be forced to absorb immense cuts, with hospitals and doctors facing huge increases in demand for uncompensated care.
  • Massachusetts would lose $1.4 billion in federal Medicaid funds for 2019, and $491 million in support for Health Connector plans.

Even if the ACA is replaced after reconciliation with programs designed to increase the insurance rate, the government would still need to raise taxes, cut spending, or increase the deficit. Reconciliation would also directly affect the most vulnerable populations in the US and across the Commonwealth, which is why it is so vital that we work to keep our health reforms in place.

Please add your voice to support affordable health care in Massachusetts and get involved today. 

-- Angela Swanson

November 17, 2016

The election puts at risk the coverage of some 22 million people nationally who depend on the Affordable Care Act for their health insurance.

What about us here in Massachusetts?

Our reforms predated the ACA. Yet repealing the ACA would be devastating. It substantially strengthened our ability to provide affordable coverage. Over 300,000 adults are enrolled in MassHealth and an additional 180,000 in Connector Care directly under provisions of the ACA. 480,000 of us and our neighbors.

Because of the ACA, we’ve been able to provide premium assistance for more people, allow children to remain on their parents’ health coverage longer, eliminate limits on benefits, provide free preventive care (including contraception) in insurance plans, and improve drug coverage for seniors on Medicare. The ACA has improved care quality, and funded community health centers, workforce development, and community-based prevention.

Massachusetts is unique proof that the ACA can reduce uninsurance to very low levels – under 3%. That’s why we must spearhead the fight to protect health reform.

We urge you to add your voice to support affordable health care in MassachusettsJoin our campaign here and donate now to help us continue our work to protect your access to healthcare.

Check out this blog to learn more about the importance of protecting the ACA. 

October 28, 2016

Health Care For All is among more than 200 health and social service organizations and leaders who signed on to a letter yesterday requesting the reauthorization of the Prevention & Wellness Trust Fund (PWTF) before the funding expires in June of 2017. 

The PWTF was established by the legislature in 2012 as a part of Chapter 224 with the aim of reducing health care costs by investing in prevention for chronic conditions like diabetes and asthma. Services supported by this Fund are available to nearly one million Massachusetts residents in all areas of the state through nine community partnerships that help keep people safe and healthy.

The letter outlines the impact chronic illnesses have on individuals and how these conditions contribute to shorter lives, lower quality of life, reduced workplace activity, and, for children, missed school days. With rates of preventable chronic conditions skyrocketing, especially among individuals from lower-income communities, it is essential that we invest in these initiatives to ensure health care equity in Massachusetts. In fact, Representative Jeffrey Sánchez, House chair of the Joint Committee on Health Care Financing, said that "prevention at the community level is fundamental” to achieving equitable health outcomes.

HCFA believes that the integrated approach offered by the Prevention & Wellness Trust Fund is a key to addressing the underlying causes of poor health and is a complement to the ongoing transformation of the health care system. We urge  the legislature to reauthorize the funding next year so that all residents of Massachusetts have a equitable opportunities for good health.

 

--Angela Swanson

 

August 10, 2016

Originally posted by the Center For Health Care Strategies (CHCS)

Achieving health equity is a growing priority among health care stakeholders. However, until recently, many efforts to achieve equity have been focused on increasing access rather than addressing specific inequities. This is particularly true in oral health, where major barriers to access such as limited insurance coverage and insufficient workforce capacity persist. As a result, the Center for Health Care Strategies (CHCS), with support from the DentaQuest Foundation, led the Advancing Oral Health Equity learning collaborative to help oral health stakeholder organizations examine the impact their programs have on oral health equity and develop targeted strategies for disparate populations.

Health Care for All (HCFA), a nonprofit advocacy organization focused on achieving high-quality, affordable, and accessible health care for all Massachusetts residents, was one of five organizations participating in the collaborative. By listening to community and stakeholder groups, as well as hearing stories through its Health Insurance HelpLine, HCFA has adopted an equity-based framework and approach throughout its work. It sees inequities in oral health care as a social justice issue, believing that the social determinants of health and the intersecting issues of racism and classism affect overall health and well-being. To learn more about HCFA’s approach, CHCS spoke to two members of HCFA’s oral health care team: Kate Frisher, oral health coalition coordinator, and Kelly Vitzthum, oral health policy analyst.

Q: What kinds of activities is HCFA doing to advance oral health equity?

A: We focus primarily on policy opportunities. One example is supporting legislation that would create a new type of mid-level dental provider, the dental hygiene practitioner, also known as a dental therapist. Dental hygiene practitioners can help fill gaps in access for communities that are most in need of dental services, including rural parts of Western Massachusetts, elderly communities, and low-income urban communities of color. We’re hopeful that this new model will become a reality in Massachusetts and will also work to ensure that mid-level providers will serve the people who need them most. It’s one thing to get a bill passed, but it’s not enough to just stop there.

Q: Which populations are you focusing your equity work on?

A: It’s really easy to just say, “We’re focusing on the Medicaid population,” and leave it at that without thinking about the sub-populations that exist within the broader set of Medicaid beneficiaries. We’re finding that the population with developmental disabilities as well as individuals who live in the rural areas of western Massachusetts are both having trouble with access to oral health care.  Even just saying that we’re “narrowing down” our focus to western Massachusetts is obviously a bit of an oxymoron because it’s a huge region.

We also know that not having culturally and linguistically competent care is a big barrier to access in some places. We were really surprised to find that although there appear to be enough dentists who speak Spanish, severely lacking are dentists who speak Portuguese, the third most common language in the state. Thus, we identified Portuguese speakers as a potentially underserved group.

Q: Are there any obstacles to your oral health equity work?

A: The biggest obstacle is the separation of oral health care from the rest of health care. A lot of the oral health disparities could be alleviated if oral health care were better integrated into the health care system. We’re pursuing structural-level changes in the way that oral health care is financed and delivered to try to “bring the mouth back into the body.”

We also see diversifying the workforce to better represent Massachusetts residents as critical, especially when you look at who is going into the dental profession. Establishing more pathways into the oral health professions through outreach to minority students, recruitment of minority faculty, and targeted financial incentives such as loan repayment programs will help.

Q: How does HCFA plan to advance oral health equity in Massachusetts going forward?

A: Through the learning collaborative, we’ve highlighted an ongoing priority: oral health surveillance. There aren’t many oral health care datasets available, so we have identified collecting those data as one of our top priorities. We are also making sure that oral health is being addressed within Massachusetts’ new accountable care organizations. Ensuring that these new delivery and financing models establish equitable ways of providing care is a critical part of the implementation process. This is in line with a broader attempt to increase the prominence of oral health at the systems level.

Progression toward oral health equity will happen with interventions that address specific barriers identified at the community level. Health Care for All’s strategies to improve oral health data collection, diversify the dental workforce and improve cultural competency will increase the availability of oral health care for those whom need it most in Massachusetts — and may serve as a promising path for other communities across the country.

--June Glover, Program Officer, CHCS and Teagan Kuruna, Communications Associate, CHCS

August 9, 2016

This blog was originally published on Community Catalyst’s blog Health Policy Hub

As states across the country look for ways to combat the ongoing opioid crisis, one overlooked issue is how we address the impact of this crisis on our communities’ youngest. Infants exposed to opioids in utero may experience a variety of potentially debilitating symptoms associated with opioid withdrawal, collectively known as Neonatal Abstinence Syndrome (NAS). As the opioid crisis and NAS receive greater attention, children’s advocates and public health professionals have pushed for more focused strategies and greater resources to assist. Efforts have focused not only on those infants specifically diagnosed with NAS, but also on additional substance-exposed newborns (SEN) who may experience problems related to other types of prenatal substance exposure.

At the federal level, the Protecting Our Infants Act of 2015, sponsored by Rep. Katherine Clark (D-MA) and Sen. Mitch McConnell (R-KY), helped bring greater attention to the issue, particularly the need to gather data to comprehensively assess the impact on infants and their families over time. Increasing awareness is an important first step in reversing the rise in newborns exposed to harmful substances. And while there are numerous efforts on the ground to combat the epidemic and support infants and their families in recovery, many are reliant on finite resources and have yet to be integrated into a system that will ensure their long-term sustainability.  

In Massachusetts, over the past year, Community Catalyst’s New England Alliance for Children’s Health (NEACH)convened a working group of practitioners, early childhood specialists, advocates and public health stakeholders to help the state take the next step to advance uniform policies across human and health services to support infants and their families. With the help of the Children’s Health Access Coalition (CHAC), the working group pushed the state to take more concrete steps to improve care for substance-exposed newborns. These efforts produced a resounding victory last month – the state’s FY 2017 budget included language establishing an inter-agency task force dedicated to addressing NAS and SEN. The relevant section declares that “all executive agencies work in coordination to address the needs of newborns, infants and young children impacted by exposure to substances.”

Importantly, the taskforce brings together state agency leaders who play an important role in the care of children and their parents. This list includes the Secretary of Health and Human Services, the Attorney General, the Commissioner of Children and Families, the Commissioner of Mental Health, the Commissioner of Public Health and the Executive Director of the Massachusetts Health Policy Commission. Additionally, an advisory council of experts and community leaders was formed from across the continuum of care for infants and parents experiencing the effects of substance use disorders. The establishment of this task force is a major step forward and presents a considerable opportunity for improving the care and outcomes for parents with substance use disorders and their children throughout the Commonwealth.

While the establishment of the task force is but one step in addressing a very large problem, it does make significant progress around coordination and communication among state agencies – one of the greatest barriers to establishing comprehensive systems of care on a state-wide basis. Due to the multiple issues involved, NAS and SEN necessitate the involvement and interaction of several agencies and departments. As states look to address NAS and SEN, the ability to coordinate effectively will be critical to ensuring the development and implementation of successful plans.

--Ben Koller, Program Associate, Community Catalyst Aliiance for Children's Health

July 25, 2016

It’s a horrible name, but a great program. And with HCFA’s support, the Massachusetts state legislature just saved its funding for this year.

“Detailing” is the term used to describe the marketing of prescription drugs to doctors, pressing them to prescribe specific drugs for their patients. Detailers are sales representatives who travel to physician practices to deliver sales pitches lauding the benefits of their drugs. Often, detailers provide a free meal and drug samples as an enticement for providers to listen to their spiel. Detailers only work for name brand drugs; there are no detailers for generic alternatives.

“Academic detailing” is just the opposite. Independent experts meet with doctors, and go over current scientific information on a class of drugs, informing doctors on all the research, and making unbiased recommendations based on comparative evidence, including cost-effectiveness. The result is better patient outcomes, and lower health care costs. One study from Harvard Medical School found that each dollar spent on academic detailing saved two dollars in prescription drug costs.

For several years, Massachusetts has operated an academic detailing program, operated by the Department of Public Health. For this coming fiscal year, the plan was to focus the $150,000 program on how to best prescribe pain killers, to avoid the over-prescribing of prescription opioids. But when the fiscal year 2017 budget was presented to Governor Baker, he vetoed the funding for the program.

Last week, the legislature overrode the veto, by a 122 to 31 vote in the House, and a 36 to 3 vote in the Senate. During the override debate, Senator Mark Montigny spoke out passionately in favor of the program:

“We're not only fighting the opiate crisis, we're also fighting price-gouging by the pharmaceutical companies. This is exactly what should be done. Instead of having folks running around offices selling things they aren't even qualified to sell half the time. I think this is a great program.”

HCFA continues to press for effective prescription drug policies that save money and improve care. In addition to support for academic detailing, our prescription drug policy agenda includes greater transparency around drug prices, and eliminating copays for cost-effective preventive care. We’re very pleased that the academic detailing program survived, and will continue to press for a consumer-focused policies in this area.

-Brian Rosman

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