Friday, August 24, 2007 State
Watch
Massachusetts Holds Hearing on Rule Requiring
Certain Residents To Contribute Copayments, Deductibles To Receive
Care
Proposed rules in Massachusetts that
would require some residents seeking no-cost care at hospitals to
contribute deductibles and copayments would weaken the state's health care
safety net, according to testimony given on Wednesday at a public hearing
on the rule, the Boston Globe reports (Dembner, Boston
Globe, 8/23).
Under the proposed rules, set to take effect
Oct. 1, uninsured residents with incomes between 150% and 200% of the
federal poverty level would be required to pay a $35 monthly deductible.
Those with incomes between 100% and 200% of the poverty level also would
be required to contribute a $5 copay for office visits in a hospital and
$50 for emergency department visits that do not result in an inpatient
admission. People with incomes between 200% and 400% of the poverty level
would pay a larger deductible based on income.
There would be no
copays or deductibles for children or for care received at community
health centers, except for a $3 copay per prescription. Under the state's
health insurance law, hospitals and community health centers will not
receive reimbursements for no-cost care provided to patients who are
eligible for insurance through Medicaid, the state-subsidized Commonwealth Care or affordable employer-based coverage
(Kaiser Daily Health Policy Report, 7/16).
Testimony
According to testimony from government officials,
health care providers and advocates, the costs of the deductibles and
copays might prevent some people from seeking care. In addition,
eligibility requirements could leave health care providers to cover the
cost of many patients who are unable to pay, opponents of the rules said.
"The continuity of their health care will come at our expense," Joel
Abrams, CEO of Dorchester House community health center, said at the
hearing, adding, "I ask you to help avoid tearing apart ... the
community-based, safety-net system." State Sen. Richard Moore (D), who
sponsored the health reform law, said in written testimony that "what must
be avoided is placing more of a burden on the hospitals and inadvertently
discouraging patients from seeking medical care."
Sarah Iselin,
the state commissioner of health care finance and policy, said, "We
recognize, and the proposal reflects, our commitment that there will
continue to be a strong safety net. But we need to align this with other
state health programs, so people who have access to affordable coverage
enroll." Iselin said state officials will consider the testimony before
issuing final rules in mid-September, and once the new rules take effect,
the state will monitor the impact on patients and health care providers
(Boston Globe, 8/23).