Expanded licensing for dental therapists, nurse practitioners and optometrists, permission for MassHealth to offer a Medicaid buy-in program, and new limited network insurance products are among the many policy proposals state senators are promoting in one of the biggest healthcare reform bills to hit Beacon Hill in years.
Senators drew a big crowd to a fourth floor meeting room Tuesday to unveil a bill that runs for more than 100 pages and a report from a working group led by Senate Majority Leader Harriette L. Chandler, D-Worcester.
Also under the bill, pharmaceutical companies would be required to report drug pricing information to a state agency, and a new statewide target would be set for reducing hospital readmissions rates.
Senators who discussed some provisions in the bill in a press conference Tuesday estimated it could eventually save hundreds of millions of dollars and said they hoped the bill could serve as a national model, pointing back to the 2006 state healthcare access law that mandated insurance coverage.
“What is now called Obamacare started right here in Massachusetts, with a Senate bill, and it became Romneycare, and it became Obamacare,” Chandler said. “I probably shouldn’t be so bold to say, but I suspect that this could become Bakercare, and I would like to see it become Trumpcare because I think this is what the country needs.”
The bill would expand coverage of telemedicine, set up a licensure process for behavioral health urgent care centers, set default rates for out-of-network billing, and reauthorize a trust fund to support prevention and wellness programs.
The bill’s initiatives, if adopted and implemented, could yield hundreds of millions of dollars in savings by fiscal 2020, Senate Ways and Means Chairwoman Karen Spilka said.
Spilka said the bill’s MassHealth reforms could save an estimated $114 million in fiscal 2020, while savings on the commercial and private insurance side could run from $475 million to $525 million. Near-term savings would depend on when changes were implemented, she said.
The bill is scheduled for a hearing before a special Senate committee — comprised of the lawmakers who developed the bill — at 11:30 a.m. Monday.
Any proposal will need buy-in from the House, where leaders have not outlined their preferred course on health care.
The bill permits MassHealth to offer what the senators described as an “optional expanded Medicaid buy-in plan for employers.”
Sen. James Welch, among the group’s leaders, said this would provide a new option for employers whose workers qualify for MassHealth coverage, allowing them to coordinate with MassHealth to offer “a MassHealth-type plan” with the cost borne by the employer.
“It’s not adding any cost to the system,” Welch said. “It’s just creating a more flexible way for employers to offer competitive plans for their employees.”
The bill picks up a Baker proposal to require employers to report information on their health insurance offerings, which the senators said would allow MassHealth to improve the targeting of its premium assistance.
It would also enroll MassHealth-eligible consumers participating in the home care program into the Senior Care Options program, with some exceptions, shifting those who do not opt out from an entirely state-funded program to a federally matched one.
The senators eschewed Baker’s recommendation to move 40,000 childless adults and 100,000 parents and caretakers off of MassHealth and into subsidized ConnectorCare plans. Referencing the unsettled nature of the federal health care debate, Senate Ways and Means Chair Karen Spilka said they were concerned about “what might happen to them and their premiums and their coverage.”
“The Baker-Polito Administration proposed a comprehensive package that was carefully developed and supported by leading members of the health care and business communities to control spending, protect taxpayers and preserve the health care safety net,” Baker press secretary Billy Pitman said.
“The administration will carefully review legislation that reaches the governor’s desk, and believes final legislation must include serious reforms that are needed to stabilize the health care safety net and protect taxpayers from picking up the tab for more worker’s health coverage.”