"Health Care For All" in lights on a bridge

A Healthy Blog

Massachusetts health care – wonky with a dose of reality

May 4, 2017

The US House of Representatives just voted in favor of repealing and replacing the Affordable Care Act (ACA). The American Health Care Act will make massive cuts to Medicaid and rip up the insurance protections in the Affordable Care Act (ACA) - but we're not giving up. Now the bill moves to the Senate, where we can still win this fight. 

All Senators, regardless of their public position on AHCA, need to hear from their constituents now.

In Massachusetts, we are fortunate that our Senators Edward Markey and Elizabeth Warren are firmly opposing this effort, but we can still play an important role in stopping this madness.

We are asking residents in the Commonwealth to reach out to friends and family in other states and tell them to call their Senators.

Numerous senators have expressed reservations about the legislation - they need to hear from their constituents that this bill is bad for consumers. Our calls, emails and rallies make a difference and remain critical. You can use Community Catalyst’s Take Action Page to find the phone number for your Senators.

Talking Points for Senate:

The American Health Care Act is terrible for consumers – especially for kids, older adults, people with disabilities and low- and middle-income families. It would strip coverage from 24 million people and raise costs for millions more, and impose $839 billion in Medicaid cuts. The Senate should reject this bill and any bill that cuts coverage and raises costs.

The AHCA would:

  • Take us back to the dark days when people with pre-existing conditions like diabetes and cancer couldn’t get health insurance. The plan would allow insurers to charge more to people who are sick, leading to premium increases upwards of tens of thousands of dollars for coverage that is unlikely to meet their health care needs.

  • Allow states to get rid of the essential health benefits, which would roll back the clock to the days of skimpy plans without coverage for maternity care, substance use disorders or mental health services. This means, for example, that women would have to pay more for coverage that actually meets their health care needs.  

  • End the Medicaid expansion and slash $839 billion from Medicaid, jeopardizing care for millions of low-income seniors, people living with disabilities, children and low-income parents.

  • Hit older Americans with an age tax that would force them to pay thousands of dollars more for the health care they need.

  • Be especially bad for kids. The Medicaid block grant option would reverse a long- standing commitment to protect low-income children – it would impose $839 billion in Medicaid cuts that would put pressure on states cut benefits, roll back eligibility and deny children comprehensive preventive care needed to stay healthy.

  • Undermine efforts to address our state’s crisis of drug overdose deaths.

  • Weaken the ACA’s protections against catastrophic costs for people with employer-sponsored coverage.

  • Mean fewer people covered, weaker protections and higher costs for consumers – all to give a tax break to millionaires and corporations. This is not what your constituents want.

(Thank you Community Catalyst for your leadership!)

April 27, 2017
 
The American Health Care Act (AHCA) was first introduced by House Speaker Paul Ryan on March 20th, 2017. The latest proposal keeps all of the bad features of AHCA, such as the $880 billion cuts to Medicaid and plans to strip more than 20 million people of their health insurance. Added to that it would allow states to gut the main consumer protections of the ACA and return to a time when insurers could discriminate against those living with preexisting conditions – charging them higher premiums and selling them plans that don’t meet their health needs by limiting benefits and increasing out-of-pocket costs.
 

Even though Congress is trying to avert a government shutdown, the health care debate remains critically important as Speaker Ryan roams the halls looking for votes in support of his bad bill.

We have a real chance to stop this. 
 
In Massachusetts, our congressional delegation has already committed to defend our gains in health care, but we can still make a difference in this battle. 
 
We're asking everyone to please contact your friends and family who live in states with Republican US representatives. You need to ask them to get in touch with their members of Congress to ensure that they don't support this dangerous bill!
 

 

Tell them how health reform has been a success, and direct them to http://bit.ly/CallCongressCC

Thank you to our partner organization Community Catalyst for the information, resources, and leadership they provide in this fight. 
March 10, 2017

Yesterday, HCFA, along with dozens of advocates, providers, faith leaders, and consumers gathered in Boston’s historic Old South Church to protest the proposed Republican plan to dismantle Medicaid and the Affordable Care Act (ACA). Speakers included:

  • Rev. John Edgerton, Associate Minister, Old South Church of Boston; Member, Greater Boston Interfaith Organization
  • Hannah Frigand, Associate Director, HelpLine, Enrollment and Education, Health Care For All
  • Sheila Belin, Health Care Worker at Boston Medical Center, 1199SEIU Member
  • Eric Fleegler, MD, MPH, Boston Children’s Hospital
  • Kathy Paul, Massachusetts Senior Action Council
  • James S. Gessner, MD,  President, Massachusetts Medical Society
  • Nassira Nicola, Boston Center for Independent Living
  • Elizabeth Mooney, Southeast and Metrowest Regional Coordinator for the Massachusetts Organization for Addiction Recovery (MOAR)
  • Dennis Heaphy, Disability Policy Consortium
  • Jennifer Childs-Roshak, MD, MBA, President and CEO of Planned Parenthood League of Massachusetts

You can read highlights of their remarks here.

Both in Massachusetts and across the nation, a broad coalition of stakeholders has emerged in fierce opposition to the Republican plan, entitled the American Health Care Act (AHCA). The opposition includes health insurers, hospitals, nurses, doctors, patients, consumer advocates, community organizations, faith organizations, groups representing people with disabilities, senior groups, and even an executive from the Center for Medicare and Medicaid Services. The unanimous opposition of all these groups, which represent the full spectrum of health care stakeholders, is stunning – and telling.

The fact is that the AHCA would have devastating consequences across the entire nation, and Massachusetts would be particularly hard hit.  The provisions in the Republican legislation would decrease coverage and increase health care costs for consumers and the Commonwealth. The AHCA reduces federal assistance to low and middle income people for purchasing health insurance, eliminates cost-sharing protections included in the ACA, and rolls back the state’s Medicaid expansion, threatening coverage for over 300,000 Massachusetts residents.

Additionally, the Republican plan calls for capping Medicaid funds, which would result in the loss of billions of federal dollars used by the state to offer health coverage to the state’s most vulnerable residents. This radical change to Medicaid would place an enormous financial burden on Massachusetts and directly threaten benefits and coverage for 650,000 Massachusetts children, 170,000 seniors and 280,000 people with disabilities.

Much of what is contained in the Republican proposal is outrageous, but there is no doubt that most egregious of all is the theft of health care from the poorest Americans to line the pockets of the very richest among us. Reverend John Edgerton, an Associate Minister at Old South Church, a Greater Boston Interfaith Organization member, put it best yesterday, “This plan disregards the right of poor people to access care they can afford, while slanderously claiming that if they lose coverage it will be because of irresponsible spending. If this plan is passed, it will ruin people financially. But worse than that, people who might have remained healthy will get sick. People who might have survived will die."

Every voice counts in this fight to defend Medicaid and the ACA. We urge Massachusetts residents to call Governor Baker, Senators Markey and Warren, and your Representative in Congress. Thank them for all they have done to protect health coverage for the people of Massachusetts. Click here for more ways to get involved.

March 10, 2017

HCFA testified before the Health Policy Commission in support of lowering the state's "Cost Growth Benchmark." The hearing was held on March 8, 2017. The benchmark sets a goal for the limit of overall growth in medical spending in the state. Entities such as insurers or hospitals that exceed the benchmark may be subject to specific sanctions under the state's health care cost containment law (summary).

In our testimony, HCFA supported allowing the benchmark - the goal for the maximum allowable increase in health costs - to go down to 3.1%, from its current 3.6% annual rate.

"We think it's important to signal to the health care community on all sides that our job of reducing health care cost growth has to be strengthened and intensified, and therefore we support allowing the benchmark to go down," Health Care For All policy director Brian Rosman said.

HCFA also urged the Commission to support concrete steps to reduce health care cost growth, such as:

  • renewal of the Prevention and Wellness Trust Fund
  • integration of oral health
  • supporting Value-Based Insurance Design
  • bring transparency to pharmaceutical prices

Read the full testimony:

Link to Resource: 

March 10, 2017

"Dentists still drill and fill teeth and physicians still look at the body from the tonsils south."

Julie Beck from The Atlantic just wrote an article that highlights the importance of dentists working alongside physicians. Read the article here.
At Health Care For All, our Oral Health Integration Project (OHIP) promotes the health of all Massachusetts residents by building a broad-based coalition advocating for the integration of dental and medical care. 
Our current objectives are to include oral health and dental services as a requirement of new state standards for Medicaid and commercial Accountable Care Organizations (ACOs). Given ACOs’ focus on whole-person health, the inclusion of oral health is critical to fully realize the potential of integrated care. For more information on OHIP, click here.
February 28, 2017

We urge you today to read the following articles that were recently published on the Boston Globe.

  1. Lawmakers' bill tops dentists' proposal in expanding access to care
    The Globe published a letter to the editor submitted by Health Care for All's Executive Director Stephen Rosenfeld favoring legislation that would create a new class of oral health providers, called dental therapists. This bill would allow them to meet the needs of vulnerable populations who might not have access to oral health care in traditional settings (see this fact sheet for more details). 

  2. Groups urge Baker to oppose possible Medicaid cuts
    As part of a national effort to ask governors in to oppose Medicaid cuts in the form of block grants or per capita caps, HCFA circulated a sign-on letter to Governor Baker urging him to continue to support full funding for Medicaid. The letter was signed by 28 Massachusetts hospitals, consumer groups, labor unions, religious coalitions and other organizations. Together we ask for Governor Baker to "oppose any federal policy changes that could threaten Medicaid coverage for thousands of poor and disabled people across the state."

  3. The Lifesaving Care Act
    This column highlights the story of Jen Fox, an intern for Massachusetts Congressman Joe Kennedy who got access to health insurance and treatment that saved her life thanks to the Affordable Care Act.

 

February 17, 2017

Join Health Care For All's contingent at the "We will Persist"- Boston Rally

As the Massachusetts Congressional delegation gets ready to go back to D.C., let's join together, stand with our allies in Congress and continue to send a clear message to Washington: We will continue to fight. Our voices will not be silenced. We will persist. We need to speak up and take action to protect our communities and to protect health care access for millions of residents.

Tuesday, February 21
2 PM - 3 PM
Irish Famine Memorial
294 Washington St, Boston, MA 02108

Speakers:
U.S. Representative Joe P. Kennedy
U.S. Senator Ed Markey                             

Sponsors:
32BJ SEIU
1199 SEIU
SEIU 888
Health Care For All
Mass Senior Action Council

 

You want to help save health care but cannot make it to the rally? No problem! You can participate on the phone banks that HCFA will be co-hosting next week with 1199 SEIU. We will be calling voters in Maine to ask senators in that state to vote against repeal of the Affordable care Act. 

 

 
February 17, 2017

Today, the Massachusetts Budget and Policy Center released a report highlighting the major federal funding sources received by the state to provide access to affordable health care, help children thrive, assist low-income families, and care for veterans.

According to the report, federal revenue currently accounts for approximately 25% of the Massachusetts state budget, totaling about $11 billion in state fiscal year 2017. Of that $11 billion, $9.44 billion comes in the form of reimbursement for state spending on Medicaid.  Federal funding for the Children’s Health Insurance Program brings in an additional $534 million. MassHealth, the state’s combined Medicaid and Children’s Health Insurance Program (CHIP), provides health insurance to 1.9 million Bay State residents, including over 645,000 children and hundreds of thousands of seniors and people with disabilities

A number of proposals expected to be debated by Congress in the coming months will certainly impact state budgets across the country, including Massachusetts.  The state’s MassHealth budget in particular faces three major threats:  repeal of the Affordable Care Act (ACA), major restructuring of the Medicaid program, and funding for CHIP.

The ACA contains a provision that expands Medicaid coverage to adults earning up to 133% of the Federal Poverty Level and increases the federal reimbursement rate for state spending on this population. The state will spend and expected $2.096 billion on the expansion population in 2017, with the federal government picking up 86% of the cost, or $1.824 billion (as opposed to 50% for most of the remaining Medicaid spending). The ACA also included a 23% enhanced matching rate for CHIP spending – increasing Massachusetts’ rate from 65% to 88%. If the ACA is repealed, Massachusetts could lose some or all of the $776 million in enhanced Medicaid funding, or even all of the $1.824 billion in federal reimbursement for the expansion population, in addition to the $139.6 million in increased CHIP reimbursement.

Congressional Republicans are also moving towards transforming federal Medicaid funding into a block grant or per-capita caps. If they are successful, rather than state’s receiving reimbursement for Medicaid spending, each state will instead receive a set amount each year – resulting in up to 25% in reductions to federal Medicaid funding for Massachusetts. These proposals simply shift health care costs from the federal government to state governments, forcing state policymakers to make difficult decisions, such as slashing eligibility, benefits and provider rates. In addition, MassHealth’s progress toward innovation – investing in keeping people health and changing the payment system to promote value – could also be constrained with the move to block grants or per-capita caps.

In addition, federal funding for the CHIP program expires in September, 2017. If Congress does not act to reauthorize and fund the program, the Commonwealth will be faced with the choice of picking up the state would have to pick up the full costs of this program, or reduce the number of children covered and the benefits they receive.

The MassBudget report drives home the point that all states, including Massachusetts, depend on a partnership with the federal government to share in the cost of providing health care to needy children, people living with disabilities, seniors, veterans, and low income and working families. If the ACA is repealed, if CHIP is not funded, or if Medicaid is gutted, Massachusetts will face significant budget challenges and difficult choices that could have devastating impacts on the ability of low-income individuals and families, children, seniors and people with disabilities to access health care services.

February 14, 2017

As the Trump administration and congressional Republicans rush to take healthcare away from 30 million Americans, increase our healthcare costs, endanger the care we deliver and threaten our jobs, our Massachusetts Congressional Delegation has been leading the charge to fight back. Our members of Congress know we deserve better, and our patients and communities do, too.

Send your thanks to our Members of Congress as part of 1199 SEIU's Valentine's Day campaign!

 

Write your own email and tell your member of Congress:

"I am a voter in your district and a healthcare worker. I am writing to thank you for fighting to protect the healthcare that my family and so many Massachusetts residents depend on. The Affordable Care Act must not be repealed without a plan to keep and improve the healthcare of our patients and consumers. Please continue fighting for a plan that protects care for 30 million hardworking Americans, preserves coverage for patients with pre-existing conditions, and maintains Medicaid funding for seniors, children and people with disabilities.Thank you again for fighting to protect quality, affordable healthcare - keep it up!"

You can also use your Facebook, Twitter and Instagram accounts to thank your member of Congress:

"My name is [name], I am a voter in [hometown] and a healthcare worker at [facility]. I want to thank our entire Massachusetts Congressional Delegation for fighting to protect the healthcare that my family and so many Massachusetts residents depend on. The Affordable Care Act must not be repealed without a plan to keep and improve our healthcare. We care for Massachusetts together, and I am proud to stand with you. Thank you again for fighting to protect quality, affordable healthcare - keep it up!"

 

Happy Valentine's Day from Health Care For All! 

 

 

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

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