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Wednesday 3 June 2009

The Joint Committee on Health Care Financing held a public hearing on Wednesday May 27th. Several bills were heard relating to insurance, the Insurance Partnership program, medical malpractice and the health care workforce.

Georgia Maheras testified on behalf of the Affordable Care Today (ACT!!) Coalition in strong support of Senator Montigny’s bill, An Act relative to coverage for chronic illness (S. 551). This bill would eliminate co-payments for all prescriptions and devices used for the treatment of chronic illness, a bold step forward in Massachusetts’s attempt to make quality health care affordable for everyone. Research has shown that increased cost sharing, especially in the course of treatment of chronic illness, serves as a barrier to patients who are seeking care. Even relatively small co-payments have been associated with lower rates of seeking preventive services and co-payments for treatment of chronic illness would only hinder the treatment’s rate of success. It makes economic and medical sense to eliminate chronic illness cost-sharing. Prevention will increase and costs will decrease. Estimates have shown savings of nearly $2,000 per patient annually, along with a decrease in mortality rates. Twelve states across the country have already eliminated it from their Medicaid programs, with successful results.

Mary Lou Buyse from the Mass. Association of Health Plans spoke in opposition to S. 551. Buyse argued that eliminating copays for chronic care would violate health reform’s mantra of shared responsibility and lead to increased costs and utilization. Buyse fervently stated that health care should not be free.

Representatives from the small business, artist and insurance communities testified on the Insurance Partnership bills: S. 530/H.1083 An Act Improving the Insurance Partnership Program, H. 1071 An Act Relative to the Insurance Partnership and H. 1078 An Act Relative to Massachusetts Artists. Health Care For All is supportive of S.530/H. 1083, which would increase eligibility for the IP to 400% fpl from the current 300% fpl level. These bills also increase by 50% the payment to employers who participate in the plan by providing coverage to eligible employees. H. 1078 goes further than S.530/H. 1083 and raises the eligibility level to 400% fpl. It also makes more extensive changes to the program, including eliminating the 6-month look-back. This bill also would allow self-employed people to receive Commonwealth Care, expand the Section 125 requirement to firms with 5 or more employees, and direct the Department of Revenue to review how Adjusted Gross Income (AGI) is calculated for individuals with a combination of self-employment and wage income. HCFA opposes H. 1071, which appears to cut back on eligibility for the IP in 2009. We support an in-depth appraisal of the strengths and weaknesses of the IP and the other health assistance programs. A comprehensive, rational framework should be devised that equitably provides help to everyone who qualifies for assistance. To read our full testimony Kathy Bitetti, Executive Director of our ACT!! Coalition partner The Artists Foundation, also spoke in support of H. 1078 and H. 1083 and urged the Committee to not let self-employed people and people with combination incomes fall through the cracks.

Two sets of bills generated much discussion: childhood vaccines and medical malpractice reform. DPH Commissioner John Auerbach and several other experts from the fields of pediatrics and public health spoke in strong support of Rep. Wolf’s bill, H.3453 An Act establishing the Massachusetts childhood vaccine program and the Massachusetts immunization registry. The experts emphasized the need to ensure that all kids receive necessary and cost-effective vaccinations. Senator O’Leary as well as Mass. Medical Society President Mario E. Motta spoke in support of his medical malpractice reform bills – S. 573 An Act providing for a fair judgment interest rate for medical malpractice actions and S. 574 An Act relative to malpractice reform; representatives from the Mass. Academy of Trial Lawyers argued in opposition to these bills.


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