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Health Safety Net Cuts: Public Hearing Feb. 26, 2016

Blowing a Hole in the Health Safety Net: EOHHS Notice of Proposed Rules

EOHHS has released proposed rules that will significantly restrict eligible services in the Health Safety Net as early as April 1. The rules can take effect only after a public notice and comment period. The attached FAQ summarized below describes the HSN program, the proposed cuts, the rationale for the cuts to the extent they have been explained, and the reasons why the cuts are a bad idea that will hurt low income people, safety net hospitals and community health centers. We hope this information will be helpful to you and your organization in preparing testimony or submitting comments opposing the proposed changes.

A public hearing is scheduled for Feb. 26, 2016 in Quincy.

MLRI Frequently Asked Questions and Answers about the HSN cuts: complete FAQ attached in Word & posted as a pdf  here:

Summary of FAQ

What is the Health Safety Net  (HSN)?

  • A program to encourage safety net hospitals and health centers to care for the uninsured and underinsured and equalize the financial burden among hospitals.
  • It protects eligible individuals from medical debt to hospitals and CHCs, but it is not insurance.

What are the proposed changes that will restrict HSN payments to hospitals and health centers?

  • Lowering the income eligibility standards for full HSN and partial HSN
  • Imposing new charges on seniors and the working poor.
  • Limiting the billing period from six months to 10 days
  • Eliminating the $30 million General Fund contribution in FY 2017.

Why are the HSN cuts a bad idea?

  • The cuts “update” the income range for HSN partial to lower income levels but the FPL has fallen far behind  actual living costs over time
  • The cuts aim to align HSN rules with rules for MassHealth and the Health Connector but HSN is nothing like MassHealth or coverage through the Connector
  • The cuts limit the billing period to encourage Hospitals and Health Centers to complete HSN applications for patients at the time of service but Hospitals and Health Centers already do this if they can
  • The cuts selectively apply the alignment rational to some billing periods and not others
  • The cuts reduce spending by shifting costs to providers and consumers and achieve no added state savings.

How do the proposed changes hurt elders and the working poor?

  • Twenty percent of HSN claims are made on behalf of elders (age 65 or older)
  • Changing the income range for partial HSN hurts the working poor
    • Most of those losing full HSN are the working poor with no affordable insurance options
    • Reducing the upper income level harms people with high medical costs.
    • There is no system for tracking when a partial HSN deductible is met.
  • The burden of medical debt negatively affects families in many ways

EOHHS is proposing fundamental changes to the basic structure of the HSN with no prior consultation with stakeholders and only one public hearing in Quincy
For more information, please contact Vicky Pulos, (before Feb 20, 2016) or Neil Cronin, (after Feb. 20, 2016) or Suzanne Curry