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Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
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Monday, February 26, 2007

Advocates step up their lobbying for broad health insurance coverage

By Alice Dembner, Globe Staff

Lobbying is intensifying over the basics of health insurance as a state board prepares to decide what level of coverage will satisfy the new mandate that everyone have insurance.

This morning, the Affordable Care Today Coalition will pressed for inclusion of prescription drug coverage, trotting out Harvard researchers and other speakers at a State House news conference to insist that payment for medicines is essential to good healthcare and to the credibility of the law.

“Excluding prescription drug coverage from health insurance plans is a simplistic approach to insure affordability,” Stephen B. Soumerai, director of the drug policy research group at Harvard Medical School, said in a prepared statement.

Studies show that individuals without drug coverage often skip taking their medicines and frequently end up sicker, he said. Drugs account for about 12 percent of all healthcare expenditures, he added, but eliminating coverage can raise costs if patients with chronic illnesses need hospitalization.

The speeches were aimed at the Commonwealth Health Insurance Connector, which is considering what should be included in the least expensive plan that will be offered to state residents who don’t qualify for subsidies. The connector staff is reviewing two sets of bids from insurers – one that covers drugs and one that doesn’t.

Taking the opposite stance, representatives of several business organizations wrote to the Connector today arguing that requiring prescription drug coverage would make plans unaffordable for small employers and their workers. The groups, including the Retailers Association of Massachusetts and several city and regional chambers of commerce, also said they oppose limits the Connector is considering on deductible and out-of-pocket costs for minimal health insurance plans.

In the letter, they urge the Connector to allow "for a wide array of products under the standard" for minimum coverage.

Many on the Connector board members appear to prefer plans that include drugs, but some are worried about driving up premium costs and about requiring coverage that as many as 163,000 people with insurance don’t have.

But the ACT Coalition, a group of healthcare providers, advocates and community groups that helped secure passage of the health insurance law, says that excluding drug coverage could undermine public support and create a sea of underinsured people.

Others who spoke include Dr. Jerry Avorn, a Harvard medical professor; state Representative Patricia Walrath, cochair of the Legislature’s Committee on Health Care Financing; and leaders of the Boston Public Health Commission, the National Alliance for the Mentally Ill and the American Cancer Society.

Posted by Karen Weintraub at 06:30 AM
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