In under 9 hours, the House went through the 275 amendments filed to the its payment reform bill, and approved the bill last night on a 148-7 vote. HCFA congratulates the Speaker, Health Care Financing Chair Rep. Steve Walsh, and other House members who worked hard to bring a landmark bill through the House.
The House did not take up the closing of the tax loophole for other tobacco products (smokeless tobacco and little cigars), or the extension of the sales tax to sugary soda. But it did agree to allocate $20 million to the Prevention and Wellness Trust Fund. Both the House and Senate bills now have a funded source of support for community-based prevention. This is a major accomplishment achieved by a coalition led by the Mass Public Health Association, that included HCFA, GBIO, Boston Public Health Commission, JALSA, the Campaign For Better Care and others.
We were pleased with a number of the amendments adopted by the House. The text of a number of amendments were changed, so we’ll need to look at the final language for confirmation. Among the amendments agreed to that we liked were:
- Rep. Chan’s amendment 3 to ensure the consumer information web site is accessible (changed)
- Rep. Andrews amendment 20 to include consumer consultation in the design of the wellness program (changed)
- Rep. Balser’s amendment 62 to strengthen implementation of mental health parity
- Rep. Brodeur’s amendment 69 to strengthen the appeals process for consumers (changed)
- Rep. Kafka’s amendment 75 to establish safeguards against underuse of services (changed)
- Rep. Sciortino’s amendment 82 to protect the privacy of patients with HIV
- Rep. Fox’s amendment 125 to strengthen patient-centered care in ACOs (changed)
- Rep. Khan’s amendment 138 to establish an independent service coordinator as part of the duals initiative
- Rep. Jones’ amendment 155 to help unemployed people get connected to benefits
- Rep. Provost’s amendment 182 to required checklists be used for appropriate procedures
- Rep. Sanchez’ amendment 221 to include outcome measures in quality evaluations
We also were disappointed at a few damaging amendments that were passed. We strongly opposed accepted amendments to count broker fees as medical expenses for purposes of determining the medical expense ratio of health plans, and an amendment making changes to the employer fair share system under chapter 58. That amendment would increase the minimum size of firms subject to the assessment from 11 to 20 workers, as well as exempt some employees from the assessment calculation.
As the bill goes to conference, the Campaign For Better Care will be working with the legislature to get a final bill that reflects the best of both the House and Senate versions. We are optimistic that the legislation can make major improvements to our health and health care system, if patients are put front and center in the process.