(Boston, MA)- “Health Care For All (HCFA) is disappointed the legislature was unable to pass a health care bill that included proposals to reduce costs and strengthen protections for health care consumers in the Commonwealth. The proposed legislation would have invested in prevention, authorized dental therapists, improved provider directories, and limited out-of-network payments for consumers, among many other important provisions.
“Consumers need access to accurate and timely information about provider networks and the legislature had an opportunity to ensure that provider directories were easily searchable, available to the public, and updated regularly. There were also provisions pending that addressed protecting patients from surprise out-of-network charges.
“There are still many barriers for people to access the oral health services they need. Dental therapists could help fill the access gap by providing high-quality dental care for people in schools, health centers, nursing homes, and other community settings. HCFA is a strong supporter of authorizing dental therapists to practice in the Commonwealth, where 530,000 people live in areas with a shortage of dentists and almost half of all children on MassHealth did not see a dentist in 2015.
“HCFA also wanted to see "pharmacy gag rules" overturned which add costs for patients when they buy prescription drugs. Contractually, pharmacists are often required to charge patients their full insurance co-pay for a drug, even if the regular price charged to uninsured people is significantly less. The contracts even forbid the pharmacist from informing the patient that the drug would be cheaper if the patient did not use insurance. Both bills called for patients to be informed of their options and charged the lower price.
“The bill could have also made progress towards expanding MassHealth assistance for seniors. Currently, an eligibility cliff drops many low-income seniors from assistance with Medicare costs through MassHealth, leaving them with only expensive Medicare premiums and out-of-pocket costs. By expanding MassHealth assistance to more low-income seniors, the state could leverage substantial new federal funding and ease their burden.
“HCFA is also a strong supporter of Prevention and Wellness Trust Fund, an effective program that supports community partnerships among clinical providers, local health agencies, and community programs to offer preventive care interventions. The pilot program expired, and each branch’s legislation provided for the program to continue.
“Failing to reach consensus on this major piece of legislation was a missed opportunity, but we hope the legislature will address these issues as soon as possible. HCFA looks forward to engaging with lawmakers in the coming months to advance these priorities and help them make a reality for health care consumers.”