The Health Care Financing Committee polled members on 44 bills Tuesday afternoon, cleaning out most of their inventory of bills for this session. Click here to see a list of the poll results.
We were disappointed that the Committee recommended to study a number of important bills. Sending a bill to study in effect kills the bill for the session. A number of these bills would have no cost to the Commonwealth and could be advanced despite the fiscal crunch. Among the bills sent to study were:
- Senator Montigny and Rep. Kulik’s bills (S. 17/H. 109) to restrict drug company use of prescribing data for marketing.
- Senator Richard Moore’s bill (S. 563) to require full tobacco cessation benefits in Commonwealth Care plans.
- Senator Richard Moore’s bill (S. 873) to make a number of changes to strengthen health reform.
The Committee approved just over a dozen bills, including a modest rewrite of the health care provisions of the Governor’s small business bill, H. 4490. (here’s our summary of the bill, and here’s our report on the hearing). The Committee redraft only makes minor changes to the Governor’s proposal. It includes provisions requiring DHCFP approval of provider contracts, requires annual open enrollment periods for individuals seeking coverage, requires insurers to offer limited network plans, and expresses a determination not to expand mandated benefits. The Committee only has jurisdiction over the health care sections; other committees have reported on their sections and these will presumably be packaged by the Ways and Means Committee.
The Committee also approved a measure (H. 1104) to force all MassHealth members into managed care organizations. Currently, most MassHealth members have a choice between two managed care options- the primary care clinician plan, or one of 4 (soon to be 5) managed care organizations. We’ve long supported choice among members, and oppose this idea. Proponents tout this as a cost-saving measure, but MassHealth officials, who have closely studied this issue, say that it would increase costs. The Senate has defeated this idea several times this year.
The Committee is still looking at a comprehensive public health bill that includes a number of HCFA-supported provisions. With time running out on the formal sessions, we’re hoping the Committee can act favorably on this measure.
MAHP and our member Medicaid managed care organizations (MCOs), Fallon Community Health Plan, Health New England, Neighborhood Health Plan, and Network Health, have long supported moving Medicaid enrollees into Medicaid managed care. The MCOs currently operating in Massachusetts have consistently been ranked as the best for treating this complex population. Our members provide high quality, comprehensive care to beneficiaries while still offering a broad choice of providers. We strongly believe that moving Medicaid members to managed care would generate significant savings to the state. Such a proposal could be a win-win both for the state and for Medicaid enrollees. The Commonwealth is now facing a tremendous budget gap which stands to be exacerbated with the loss of FMAP funds. In times like these all options for savings, especially those that don’t involve cuts to benefits and services should be on the table.
MassHealth members face unique challenges; they have much higher rates of poor health, fewer resources, and lower health literacy levels than commercial health plan members. Medicaid MCOs are organized and structured to meet the needs of this population and perform in the top ten percent of plans for quality measures that evaluate preventive care and chronic disease management. All of the Commonwealth Care members and a large majority of the commercial population are enrolled in managed care today. We believe that it is illogical to treat the Medicaid population any different than the rest of the population, particularly when they could benefit the most from high quality coordinated care.
Additionally, the Commonwealth’s Medicaid MCOs provide their members with benefits and services that are currently not available to those enrolled in the Primary Care Clinician (PCC) plan. Moreover, it has been estimated that it would cost the state millions to enhance to PCC Plan to provide these same basic care management programs, such as preventative health programs aimed at prenatal and high risk pregnancy, primary care appointment reminders, asthma management, nurse triage telephone lines, and child immunizations.
Unfortunately we have never seen the Administration’s full analysis of the cost of moving to a managed care model in Medicaid; however, numerous independent studies have demonstrated that moving to an all-MCO model saves money for state Medicaid programs and improves access to quality and coordinated care. We believe it is our continued responsibility, as partners in health care reform, to look for creative ways to reduce costs. For these reasons we have supported language in the House and Senate FY11 budgets calling for a study of the potential savings to the Commonwealth of moving to an all-MCO model. Traditionally, there have been only three ways to control costs within the Medicaid program: cut provider rates, cut benefits, or cap eligibility. We now have the opportunity to explore an alternative and we ask that you join us in supporting this study.
Sarah Gordon
Vice President of Legal Affairs
Massachusetts Association of Health Plans