Senate approves broad health care bill

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The Senate on Nov. 9 approved sweeping health care legislation intended to put the brakes on the rapid growth in costs in Massachusetts, a trend that has been stressing the finances of families and businesses as well as state and local government budgets.
 
In a statement, Senate Majority Leader Harriette Chandler said the Senate bill focused on “short- and long-term goals on how to fix our health care system to lower costs, improve outcomes and maintain access.”
 
The bill features a number of short-term measures designed to reduce costly hospital admissions and readmissions through the use of community-based Mobile Integrated Health (MIH) programs, which could involve municipal first responders and other local service providers. These would include efforts to reduce the use of hospital emergency departments.
 
Other provisions in the bill are intended to reduce the need for post-acute care institutional support, boost oversight of how prescription drugs are provided, and establish out-of-network provider default payment rates.
 
The Senate Ways and Means Committee recommendation, and the final version of the bill, did not include earlier proposals that would have regulated and capped amounts charged locally for emergency medical services – essentially ambulance fees that are charged to insurers. These proposals, which had been opposed by the MMA, would have substantially reduced municipal EMS revenue and resulted in service cuts or a shift in costs to the local property tax levy. The MMA was part of a coalition that included local fire chiefs that met with legislators and staff to explain why fee caps would undermine municipal EMS services.
 
The Senate bill includes a number of long-term health care measures that would increase the availability of health care providers by expanding licenses for certain dental, nurse and other medical practitioners, make changes in access to behavioral health care, and provide new options to structure limited and tiered network health insurance plans.
 
Following the vote, Senate Ways and Means Chair Karen Spilka told the State House News Service that the bill could provide $114 million in savings for the MassHealth program and about $500 million from “commercial market reforms” by 2020.
 
The Senate debated 162 amendments covering a range of issues. One adopted amendment would require the state to develop a “single payer” benchmark that would measure the cost of a single payer health care system for all Massachusetts residents. The proposal would require the state’s Center for Health Information and Analysis to compare actual health care expenditures to the benchmark for 2016, 2017 and 2018 to determine if there would have been savings in those years, while expanding health care access, under a single payer system. If the analysis shows savings, the state’s Health Policy Commission would be required to file with the Legislature a “single payer health care implementation plan” and would be authorized to recommend legislation to implement the plan.
 
The Senate-approved bill has been sent to the House for review. Rep. Peter Kocot, House Chair of the Joint Committee on Health Care Financing, said he hopes to draft a bill for debate early next year.