House Begins Budget Debate: HCFA’s Amendment Guide

This week the House begins debate on its version of FY 2011 budget (see the just-issued in-depth analysis by the Mass Budget and Policy Center). Representatives have proposed over 800 amendments (full list and summaries), which will be considered over the week. Based on past practices, we expect most of the amendments to be dealt with as part of a consolidated amendment concerning health issues, with a few pulled out for individual debate.

The amendments include important proposals to provide adequate resources for vital health programs and maintain critical policy initiatives. Others would reverse progress and harm overall health. Below are our comments on a number of key amendments HCFA supports and opposes.

The list below does not include revenue amendments, which will be covered in another post.

We strongly urge everyone to call your Representatives and share your thoughts on these amendments.

SUPPORT:
Preserve Oral Health Benefits – Amendment #547, filed by Rep. Scibak, protects MassHealth adult dental benefits. The HWM budget authorizes the elimination of many dental benefits which would affect nearly 700,000 people in Massachusetts, including over 100,000 seniors. Eliminating dental coverage results in more spending for costly services in emergency and inpatient hospital settings due to dental infections. The long-term cost of eliminating adult dental care is 2.5 times more than the cost of providing care.

Strengthen Commonwealth Care Bridge Program – Amendment #507, filed by Rep. Cabral, stops cuts to the Bridge program for legal immigrants. The House budget recommends funding the Commonwealth Care Bridge program, the reduced-benefit plan for legal immigrants, at $60 million. The language closes the program at its current membership, locking out over 13,000 eligible people. Rep. Cabral’s amendment would increase funding to $75 million and remove the cap on the program.

Protect DPH Quality Initiatives – Amendments #169 and #170, filed by Rep. Provost, fund critical health protection programs. DPH’s Division of Health Care Quality and Infection Prevention and Control Program both do great work that continues the progress Massachusetts has made in health care cost, transparency and safety. The amendments increase funding for these divisions so they can continue protecting consumers.

Reduce Health Disparities – Amendment #495, filed by Rep. Rushing, adds language to the budget to create an Office of Health Equity in EOHHS. The office would be tasked with preparing an annual health disparities report card with regional disparities data, evaluating effectiveness of interventions, and replicating successful programs across the state.

Restore Prescription Advantage Benefits – Amendment #293, filed by Rep. Allen, and Amendment #571, filed by Rep. Hogan, increase funds for the Prescription Advantage program, which assists low-income elderly and some disabled individuals facing unaffordable prescription costs. The program has been cut dramatically over the past years. Also, Amendment 480, filed by Rep. Fernandes, insures that programmatic cost savings will be put back into the program to restore benefits that were cut earlier.

Reduce Drug Costs and Improve Care – Amendment #574, filed by Rep. Grant, restores funding for the state-sponsored evidence-based outreach and education program, often called “academic detailing.” This program provides health care providers with balanced information about the effectiveness, safety and costs of all prescription drugs on which they can base their prescribing decisions. Our friends at The Prescription Project blogged this week on how valuable objective information is, emphasizing that these programs save costs and improve clinical care.

Enforce Pharma Marketing Rules – Amendment #576, filed by Rep. Grant, restores needed funding so the pharmaceutical and medical device marketing oversight program can comply with implementation requirements. The program includes data collection and a comprehensive, consumer-friendly website that will show how much money the pharmaceutical and medical device industries are spending on prescribers in Massachusetts. This program gives Massachusetts patients and consumers the opportunity to follow the money and make safe and informed treatment decisions with their clinician.

OPPOSE:
Raise Insurance Premiums – Amendments #153 (James M. Murphy) and #791 (Steven M. Walsh) would allow some small businesses to exit the small group insurance market and form their own pool. By breaking up the broad group market, these amendments will do nothing to reduce premiums for small businesses and will hurt more than they will help. They undermine important insurance reforms implemented by the Legislature over the last two decades to guarantee availability and renewability of health coverage and the creation of broad insurance rating pools. The result would be higher health insurance premiums for the vast majority of small businesses.

Raise Drug Costs – Amendment #78 (Jones) would undermine the state’s cost containment efforts and increase health care costs. The amendment allows drug manufactures to distribute coupons, a marketing tool used by the pharmaceutical industry to drive patients towards more-expensive, high cost brand-name drugs. Coupons have been estimated to add a 1% to annual health care premiums. This expense would be borne by consumers, employers and the state.
-Mehreen Butt