Further health care reform necessary, speakers say

Health care reform could once again become state controlled under the Wyden-Brown healthcare bill, said Judy Ann Bigby during a video conference held at the Harvard Kennedy School, on Monday.

Bigby, the Secretary of Health and Human Services in Massachusetts, along with Len Nichols, a healthcare economist and John McDonough, a Harvard School of Public Health professor, met with Bostonians to discuss healthcare reform initiatives, such as new policies involving state waivers against federal healthcare and healthcare exchange systems between states.

The Wyden-Brown bill, introduced in November by Sen. Scott Brown of Massachusetts and Sen. Ron Wyden of Oregon, would allow states to apply for waivers against the federal health care program as soon as 2014, as opposed to 2017.

Bigby, Nichols and McDonough stressed the importance of setting up a healthcare information exchange between states as a way to provide extensive healthcare, as well as share advice with other states.

Massachusetts currently has an exchange with other states in New England and is hoping other states will follow suit.

The parameters and final rules about national healthcare exchanges have not yet been determined, but Bigby said it is important to keep flexibility in mind when thinking about different states.

Massachusetts has special circumstances, because of its close proximity to its neighbors and the high numbers of people that travel between states daily. However, the needs and uses of other states needs to be taken into account, said Nichols.

While Massachusetts already has an exchange, healthcare representatives said they want to see it expand, especially in providing care for underprivileged citizens. This will be mainly implemented through The Connector, a subsidized program for low-income residents.

Bigby said it is important to provide consistent coverage to these individuals.

“We need to be aware that low income people don’t have static lives and move back and form in terms of eligibility for healthcare. When see this type of movement we want to make sure it doesn’t create gaps in coverage and it is seamless,” she said. “We will use this program to implement this.”

McDonough said that despite idea that federal healthcare would mean “a federal takeover,” state healthcare is already heavily funded by the federal government.

There would ironically only be a “federal takeover in states that refuse to implement the exchanges.”

Bigby said that with budget cuts, it is difficult to decide where to allocate funds to the most important projects.

“Some people have been calling these last few years a Medicaid desert,” said McDonough.

Amanda Cassel Kraft, a resident of Cambridge, said funding for the programs was one of her biggest concerns.

“We need to embrace expanding coverage, but as they said, we don’t completely know how to reduce cost,” she said.

While cost is an issue Thomas Kim, a resident of Cambridge, thought it was “simply a big step to begin having a conversation about Massachusetts’s healthcare exchange.”

“It’s interesting just to hear the dialogue about what’s going on in D.C. and other states,” he said. “Massachusetts is a demo state when it comes to healthcare exchange programs, and it’s nice to see that D.C. respects us.”