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A Healthy Blog

Massachusetts health care – wonky with a dose of reality

February 28, 2017

The Boston Globe ran two opinion pieces yesterday on employer responsibility in health care and the need for increased transparency in prescription drug pricing, both of which Health Care For All supports

An editorial expressed support for the concept put forth in Governor Baker’s budget proposal to require a contribution for  employers that provide inadequate health insurance coverage to employees, or do not provide coverage at all. Specifically, the Governor’s proposal would require employers with at least eleven full time employees (FTEs) to cover at least 80% of their workers or to pay a penalty of $2,000 per FTE. This assessment would be calculated on a sliding scale, meaning that the closer employers get to the 80% coverage benchmark, the less they would pay. HCFA agrees with the new employer contribution proposal. Governor Baker’s suggestion closely resembles the employer responsibility law that was originally included in Massachusetts’s 2006 health reform law. The state requirement  was repealed in 2013 in preparation for implementation of the Affordable Care Act (ACA)’s employer responsibility provisions. However, especially with the ACA in jeopardy, it is critical that health coverage remains a shared responsibility between employers, employees, insurers, payers, and providers, and that Massachusetts employers continue to pay their fair share.  

The second Globe article, an op-ed by Eric Schultz, the president and CEO of Harvard Pilgrim Health Care, lays out a compelling case for increased transparency for prescription drug prices. As Schultz points out in the article, prescription drug prices continue to grow at a furious pace and the United States continues to pay disproportionately high prices for both name brand and generic drugs. As an example, Schultz cites Harvoni, a drug used to cure hepatitis C, which costs $94,500 for a twelve week regimen in the United States, while it would cost essentially half that amount in the United Kingdom and only $900 in India. Schultz points out that it would be cheaper for Harvard Pilgrim to fly a member with hepatitis C (along with a guest) back and forth from the Cayman Islands twice, pay for the member to purchase Harvoni through a Cayman medical facility and receive follow-up testing and screenings, and treat the member to a nine day all-expenses paid vacation on the Cayman beaches– than it would to treat the member here in Massachusetts.

Clearly there is a problem with the way prescription drugs are priced in Massachusetts and across the United States. This is largely due to a lack of transparency. Health insurers routinely negotiate discounts and rebates with drug companies, yet insurers are not allowed to disclose publically the cost of those discounts. In addition, drug manufacturers do not disclose the amounts spent on administrative overhead, marketing, and research and development, all of which remain hidden from public scrutiny.

Health care costs continue to rise in Massachusetts, and a leading driver of cost growth is the rising cost of prescription drugs. From insulin to epipens, life-saving drugs have caught headlines and public attention for massive price increases (insulin prices have more than tripled since 2003, while epipen prices have increased six fold in the past decade). That is why HCFA is supporting a pair of bills recently introduced in the State House, H. 1228 and S. 652. Both bills would empower state agencies to collect information on costs of production from drug manufacturers and ensure that the Commonwealth is paying a fair price for prescription drugs. These legislative proposals are an important first step towards ensuring that Massachusetts consumers can afford critical medications, and that insurers won’t have to pay the equivalent of a Caribbean vacation to provide access to life-saving treatments here in the Commonwealth.   

                                                                                                                                                       - Alec Lebovitz                                                                                                                                           

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! 

 

 

February 14, 2017

Nick Littlefiled speaking at HCFA's 2014 For The People event

All of us at Health Care For All were saddened to hear of the loss of Nick Littlefield in early February. Nick was a longtime champion of health care reform in America and Massachusetts, and his integrity and commitment to the cause will never be forgotten. Beginning his career as a lawyer committed to ethical practice and principles, Nick served as an assistant United States Attorney, taught at Harvard Law, was a leading partner at a Boston law firm, and fought public corruption as the chief counsel of the Ward Commission.

However, we here at Health Care For All will remember Nick most as the longtime lead health care staffer for the late Senator Ted Kennedy. For over a decade, Nick and Senator Kennedy fought tirelessly to extend and enhance health care coverage to millions of Americans. Together, they struggled to promote progressive causes such as protecting children’s health, securing family and medical leave for working families, cementing civil rights in the health care system, and fighting for the most vulnerable. Included below is a sampling of some of the crucial legislation that Nick Littlefield was instrumental in advancing:

  • The Ryan White CARE Act
  • Medicare Part D
  • The Child Care and Development Block Grant
  • The National Health Service Corps Revitalization Amendments
  • The Employee Pension Protection Act
  • The Civil Rights Act of 1991
  • The Drug-Free Schools and Communities Amendments
  • National Institutes of Health Revitalization Act
  • The Family and Medical Leave Act
  • The National and Community Service Trust Act
  • Health Insurance Portability and Accountability Act of 1996
  • The Children’s Health Insurance and Lower Deficit Act
  • The State Children’s Health Insurance Program
  • The Americans with Disabilities Act
  • The first minimum wage increase since 1981

HCFA honored Nick at its annual “For The People” event in 2014. Still strong despite his advancing illness, Nick brought a message of hope and perseverance in the fight for health care justice. You can see his talk here:

As we mourn Nick, our thoughts are with his wife, his three children, and his grandchildren. Through his work with Senator Kennedy, Nick was able to improve the lives of millions of Americans. His talent and dedication made our nation healthier and more humane. For these reasons and more, Nick is deserving of tremendous admiration. He will be sorely missed.

A memorial service will be held at Sanders Theater in Cambridge, Massachusetts on Friday, March 3, 2017, at 11:00 am.    

 -The Staff of Health Care For All

January 25, 2017

With the launch of a new legislative session, we at HCFA are excited to announce a new legislative agenda that advocates for a more effective and consumer friendly health care system here in the Bay State.

HCFA worked with a diverse group of legislators in both the House and Senate to file a broad package of legislation. The proposed legislation includes the following proposals:

 

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 13, 2017

Congressman Jim McGovern of Worcester spoke this morning as the U.S. House opened debate on the repeal of the Affordable Care Act. He spoke eloquently in defense of health care as a right:

“It is a cruel thing to do to take away people’s health care. We believe that health care ought to be a right, I know you don’t. We believe health care protections ought to be in law, you believe they ought to be up to the insurance companies. But this is a lousy thing to do. We’re gonna fight you on this. This is a fight worth having. Protecting people’s health care is something we should all be dedicated to and we’re going to fight you on this.”

Watch his speech, and the full text is below:

Full Text of Congressman McGovern’s Floor Speech:

“For nearly seven years my Republican friends have railed against the Affordable Care Act. Their well-funded allies have spent billions of dollars distorting the ACA and lying to the American people about what it actually does. And for nearly seven years, there has not been a single comprehensive health care bill brought to the floor by Republicans as a replacement for the Affordable Care Act. Not one!

“We have voted over 60 times to repeal the ACA on the House Floor! I’d be the first to admit the ACA is not perfect. But rather than work together to tweak it, to make it better, all we get from them are repeal bills, repeal bills, repeal bills. And let me again point out – not once, not once was a replacement bill offered.

“Not only do Republicans not have a plan to replace the Affordable Care Act and protect access to health care for more than 20 million Americans who gained coverage, they can’t even agree on a timeline for when they’ll pass their replacement.

  •          President-elect Trump says repeal and replace will be done on the same day and he wants it to happen now.
  •          Rep. Steve Scalise said Republicans will replace the ACA over the course of the next few months.
  •          Sen. John Thune said it could take two or three years for the replacement to be implemented.
  •          Rep. Chris Collins said Republicans have six months to work out the replacement plan. 
  •          Sen. Mitch McConnell refused to even give a timeline, just saying it would happen.

“While Republicans fight for each other over timelines, I think it’s appropriate to ask: If they did have a replacement, what would that replacement be?

“And what, specifically, would they replace the ACA with?

“Well, President-elect Donald Trump has the answer! When asked what we should replace Obamacare with he said, and I quote, “Something terrific.” When pressed for details and more specificity, he said “Something that people will really, really, really like.”

“You can’t make this stuff up! It would be laughable if it weren’t so tragic.

“It’s tragic because what Republicans are trying to do is take health care protections away from millions and millions of families.

“No one in Congress has to worry about health care if the Affordable Care Act is repealed. And the Donald Trumps of the world certainly don’t have to worry about health care if the Affordable Care Act is repealed. If someone in their family gets really sick – they’ll just sell some stocks or close down another American factory, or not pay their workers – as our President-elect has been known to do on many, many occasions.

“But for millions of Americans it will be a different story. Repealing the ACA would mean over 30 million Americans would lose coverage, including nearly 4 million children; more than 52 million individuals with pre-existing conditions could have coverage rescinded or see their premiums dramatically increased; millions of young adults would be unable to stay on their parents’ plans until they are 26; over 14 million individuals enrolled in Medicaid under the expansion would lose coverage; and nearly 140 million individuals with private insurance would lose access to preventive services without co-pays or deductibles.

“And millions of seniors would see their prescription drug prices increase because it would re-open the so-called doughnut hole that the ACA has begun to close.

“Republicans want to slash Medicaid, a health care program that does a lot of good and enables mothers to work their way out of poverty by providing affordable coverage for their children.

“And as someone who represents Massachusetts, this is especially personal because Medicaid is one of the best tools we have in the fight against opioid addiction, providing real care for the addiction and the underlying conditions that drive the opioid epidemic in our communities. Repealing Medicaid expansion under the ACA would rip coverage away from an estimated 1.6 million newly insured individuals with substance use disorders.

“That’s what’s at stake – and that’s what my Republican colleagues are so happy, so giddy, and so excited to do. It is sad. It is pathetic.

“But – they’re moving forward anyway – with no replacement in sight. I suppose they can roll out their oldies but goodies – like health savings accounts or their other healthcare prescription – take two tax breaks and call me in the morning.

“But that doesn’t do it.

“We have a complicated health care system, no doubt. I wish it were simpler. That’s why I’ve always favored a single-payer system and that is why I favor a public option.

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