1. MassHealth Defense Campaign Presentation For: Grantmakers in Health Health Care For All April, 2003

2. Who is Health Care For All? We are building a movement of empowered people and communities with the goal of creating a health care system that is responsive to all people, particularly the most vulnerable. We are dedicated to making quality care the right of all people and support a health care system that is universal, comprehensive, and equitable.

3. HCFA’s accomplishments legislation and regulations Medical Security Plan CommonHealth Children’s Medical Security Plan Chapter 203 – Access expansion to 300,000 Prescription Advantage Non-Group Reform Non-profit Hospital and HMO Guidelines Interpreters’ Law

4. The Last Five Years Between 1998 and 2000, uninsured in Massachusetts decreased According to state survey: 5.9% of population, 365,000 people in 2000 vs. 8.9% of population, 496,000 people in 1998 Kaiser Foundation CPS analysis: 10.6% in 99-00, 575,000 people

5. MassHealth Enrollment Increases MassHealth enrollment has increased by 300,000 since 1997 44% increase in enrollees In 2002, 988,000 people were enrolled in MassHealth 15% of the state’s population 21% of kids 7% of adults

6. Source: MTF, 2002e based on Governor's supplemental requests to date; 2003p Medicaid based on House 1, total budget based on MTF projection of 3% growth over 2001. MassHealth Costs Surge

7. The Perfect Storm September 11, 2001 Economic Recession Increasing Unemployment State Budget Pressures $3B deficit projected for FY04 Rising Health Care Costs

8. Leaders Target MassHealth For Cuts Adult dental benefits eliminated (1/02) Dentures, eyeglasses, prosthetics, orthotics, chiropractic therapy eliminated (1/03) Children’s Medical Security Plan capped (11/02) Coverage for 50,000 eliminated (4/03)

9. The MassHealth Defense Group With key support of Blue Cross Blue Shield Foundation and The Boston Foundation, Health Care For All takes “big tent” approach to building a coalition Physicians, nurses and other providers Hospitals Insurers Labor Unions Health and Public Health Advocates Grassroots Advocates Unusual allies – business leaders, etc.

10. MassHealth Defense Campaign Budget Blue Cross Blue Shield of Massachusetts Blue Cross Blue Shield of Massachusetts Foundation The Boston Foundation Boston Medical Center Cambridge Health Alliance Children’s Hospital Harvard Pilgrim Health Care Massachusetts Medical Society Neighborhood Health Plan Partners Health Care Tufts Health Plan UMass Memorial Health Care $167,500 Total Budget

11. Elements of the Campaign Consumer Involvement and Public Action Communications Research and Education Coalition Building Legislative Advocacy

12. Consumer Involvement and Public Action Identify and organize consumers affected by MassHealth cuts Mobilize community leaders Organize providers Organize demonstrations, phone banking and letter- writing campaigns Establish a committee of prominent leaders

13. Communications Develop strategic plan Explore earned media opportunities Faces Campaign Images and stories of consumers Images and stories of providers Internet & Web-based advocacy State polling & focus groups Harris Berman, M.D. (at podium), CEO of Tufts Health Plan

14. Research & Education Develop policy briefings: MassHealth: What It Is. Why It Works. The MassHealth Cuts: What They Are. Why They Don’t Work. What We Can Do. What to do about Uninsured Adults Losing Coverage in MassHealth Basic Detail economic and human impact of MassHealth cuts Develop alternative cost saving proposals

15. Coalition Building & Maintenance Establish broad-based coalition of 150 members, including: Massachusetts Medical Society, Massachusetts Hospital Association, United Way of Massachusetts Bay, Massachusetts Teachers Association, Tufts Health Plan, Blue Cross Blue Shield of Massachusetts Maintain internal communications: bimonthly meetings email updates action alerts up-to-date website

16. Legislative Advocacy Develop legislative strategy Identify legislative allies Engage legislators to disseminate materials to colleagues and act as sponsors of public events and media outreach Mobilize sub-committee of MassHealth Defense Group to implement strategies

17. Next Steps – Protect MassHealth From Cuts Document impact of cuts Develop policy briefings: Veterans People with disabilities Children Work to expand revenue base Partner with education and other advocates

18. Next Steps - Over the Next Year Redefining Victory Protect core programs Significant revenue increase Create framework for future expansions Develop stronger coalition to keep health access on political agenda Develop stronger voice for MassHealth recipients