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| STATE HOUSE NEWS SERVICE June 8, 2005 |
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Consensus health care access proposal eyed for the fall By Amy Lambiaso STATE HOUSE, BOSTON, JUNE 8, 2005…..With several proposals on the table, federal money at stake, and thousands of people calling for change, Beacon Hill leaders on Wednesday said they hope to have a consensus plan to increase access to affordable health care by the fall. Gov. Mitt Romney, Senate President Robert Travaglini and House Speaker Salvatore DiMasi have each said in recent months that they plan to advance reforms to the state’s health care system through the legislative process to reduce the number of uninsured residents, with each of them calling it a top priority. And today, with a backdrop of nearly 1,000 advocates and stakeholders in the industry here for a public hearing on the proposals, Travaglini said the state needs to act promptly to send a positive signal to hospitals and other providers and it needs to act to prevent losing federal funding. “Each day we wait is another day where too many citizens go without health insurance, and where we all pay too much for health coverage,” Travaglini said in his testimony today before the Health Care Financing Committee, noting that the hospital fiscal year begins in October. Committee member Rep. John Scibak (D-South Hadley) said he believes the committee will work to have comprehensive legislation in place by the fall, as Travaglini suggested in his testimony. “This is the most compelling issue we are facing,” he said. “It reaches across every area and affects every person.” If that plan is not in place by July 2006, Romney says the state stands to lose $585 million. Springfield resident Luz Oquendo-Mateo told a noontime rally of hundreds of supporters that she is battling diabetes and a chronic thyroid condition, but has to fight to get medications paid for by MassHealth. “It upsets me when there are certain medications they’ll pay for, like Viagra, but they won’t pay for my thyroid condition,” she said. Romney and Travaglini have offered similar plans to increase the number of residents enrolled in Medicaid, reform the system for treating the uninsured, and offer a new health insurance product that may be more affordable to employers and consumers. Insurers say producing a scaled-down product is possible, but will require dropping some of the state’s 16 mandated areas of coverage. “Because we’re all saying the same general thing, and because the insurers and the providers are also saying the same thing, I think you’ve got the kind of convergence, alignment if you will, of the moons and the stars to suggest that we have the kind of pull that will bring that tide over the barrier,” Romney told reporters today following a rare appearance before a legislative committee. Kathleen Casavant, treasurer of the Massachusetts Chapter of the AFL-CIO, said health insurance is the number one issue at the bargaining table for workers and employers negotiating contracts. She also recognizes the common goal of reforming health care. “Many of us don’t sit at the same table, but we’re united on this issue,” Casavant told lawmakers. Romney’s proposal to create a more affordable product that gives insurers more flexibility in covering certain conditions and treatments – known as Commonwealth Care – was not before the Health Care Financing Committee. The governor’s plan will be heard by the Financial Services Committee at a later date, but Romney vowed today to work in a bipartisan fashion to reach the end goal of extending health insurance to the more than 500,000 residents currently without. Massachusetts currently spends more than $11 billion a year on health care programs. Roughly $1 billion of that taxpayer money is spent on treating those without health insurance, on average $3 million per day. Romney’s plan would shift the state’s current resources to cover more people and require some additional state spending, while Travaglini has proposed using $168 million from the state’s reserve funds, with the intention of receiving $60 million in federal reimbursement. His plan is designed to reduce the number of uninsured residents by half within the next two years. A separate proposal, sponsored by Health Care For All and a coalition known as the ACT! Campaign, would add 50 cents to the state’s $1.51 per pack cigarette tax and require employers to offer health insurance or pay into a state fund to pay for expanding health care access. Travaglini, like Romney, opposes new broad-based taxes or employer mandates to solve the problem. “No responsible person would suggest that we can expand health insurance to everyone, cut health care costs, and improve quality without spending more money on health care and without imposing any mandates on businesses,” Travaglini said. “But we must ensure that our proposed solutions do not cause more harm than good.” Romney believes that some new revenue is needed to make the necessary reforms, but the governor says the state can do it by spending its current dollars more efficiently.“We don’t need new taxes to provide health care to all of our citizens,” Romney said. “By virtue of what we’re seeing in our economy and the tax revenues we’re seeing, we can cover all of our citizens without a new tax.” Business leaders are hopeful that a final solution will not include a mandate for employers to offer coverage, and hope lawmakers take a step-by-step approach to accomplishing the end goal. And while some also acknowledge that new revenues are needed, others say eliminating some administrative overhead and modernizing some procedures will help save money. “The economy is still fragile,” said Richard Lord, president and CEO of Associated Industries of Massachusetts, adding that he believes a portion of Travaglini’s proposal to assess a fee on employers that don’t offer health insurance and whose employees subsequently seek care at emergency rooms is essentially an employer mandate. Hospitals and providers that treat the uninsured are partially reimbursed for that treatment by the state’s uncompensated care pool, which many state leaders say is an inefficient system and a financial drain. According to preliminary findings by Inspector General Gregory Sullivan released this week, roughly 20 percent of patients that turn to the uncompensated care pool for treatment are employed. The audit, which looked at data from 2003 and 2004, found that in 2003 there were 268,712 employed users and 317,827 in 2004, costing $153.5 million and $205.7 million for patient care, respectively. Business leaders said many employers may not be able to afford the current health insurance products offered, and cautioned against instituting a requirement. Physicians and health care advocates say the state must do whatever possible to reform the system and ensure that there is sufficient access to preventative care, such as cancer screening and visits to general physicians. Massachusetts Medical Society President Dr. Alan Harvey said it is “far less expensive” to offer preventative care than to have patients turning to the emergency rooms for treatment at a later stage. The Rev. Hermon Hamilton, co-chairman of the Greater Boston Interfaith Organization, said his group is prepared to collect 40,000 signatures or more to advance a question to the ballot that would offer a plan for expanding access to affordable health insurance. “Just in case you cannot act politically, we will do it for you,” Hamilton told the committee. He added: “whatever it costs is worth our paying.” One question regarding health care coverage is already headed for the statewide ballot, should it be approved by lawmakers sitting in a Constitutional Convention this session. The amendment’s sponsor, Barbara Roop, said today that her amendment is intended to lock into the constitution the goal of covering all residents with health insurance. The proposals currently on the table would not reach every citizen, but build on different ideas for reforming the system, she said. “Achieving that goal will require locking in the expansions enacted by this Legislature and enacting further reforms to cover the remaining uninsured, control costs, improve quality and simplify and streamline our health care system,” Roop said. The amendment “is designed to lock in progress as it’s made and to keep the goal of covering everyone front and center until the whole job is done.” Sen. Mark Montigny (D-New Bedford), who worked with John McDonough, a leading health care advocate and former state representative, to institute the last major health care reform in Massachusetts more than 10 years ago, rallied today for the plan being pushed by Health Care For All. He said it is a “question of morality” that some residents do not currently have health insurance. “Nobody is fine, frankly, except the lobbyists and lawyers and providers,” Montigny said. “It starts with a goal that we will cover everyone and we’ll find a way to pay for it.” |
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