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The Health Care

Constitutional Amendment

What will this Amendment do?

  • Ensure universal, continuous access to affordable health and mental health care.
  • Require elected officials to find a way to make sure every Massachusetts resident has access to affordable health insurance covering medically necessary health and mental health care services including prescription drugs and devices.
  • Give voters the final approval over a comprehensive plan to implement the Amendment.

Who are the Amendment's supporters?

  • The 71,385 registered voters from every legislative district in the Commonwealth who signed the petition to refer the Amendment to the Constitutional Convention.
  • The army of volunteers – doctors, nurses, medical students, patients and their families, small business owners, health care advocates, union members, college students, community leaders and many others – who collected almost 90,000 signatures in 8 weeks in the fall of 2003.
  • The 130 organizations, unions and businesses representing almost 500,000 people that have endorsed since the campaign began.
  • The Amendment’s 52 dedicated legislative co-sponsors who made sure the Amendment came to a vote in the 2004 Constitutional Convention.
  • The 153 legislators who voted YES on July 14, 2004.

Why do we need to do this?

  • Health care costs and premiums continue to skyrocket with no end in sight making coverage unaffordable for more and more Massachusetts residents.
  • Premium increases have outstripped wage growth every year but one between 1988 and 2004 – insurance costs grew 48% or 3.5 faster than wages in the last three years alone.
  • Fewer people get their insurance at work as soaring premiums make insurance unaffordable for employers, particularly small employers, and for their workers and retirees.
  • The state has drastically cut insurance and public health programs, often the last resort for lower-income residents, in order to balance the budget.
  • There are over 600,000 long-term uninsured who often go without needed care and live sicker lives and die sooner as a result.
  • Access to affordable coverage will mean better health and financial security for Massachusetts families and increased productivity and profitability for Massachusetts businesses.

Where's the money?

  • There is already enough money in the system to pay for universal coverage.
  • $1.1 million in FY’05 from taxpayers, hospitals, employers and the insured to pay for uncompensated care for the uninsured.
  • $1.4 billion in out-of-pocket for care by the uninsured and underinsured.
  • $2.5 billion in savings from information technology upgrades.
  • Over $1 billion spent on avoidable hospitalizations each year.
  • Additional savings from reducing the 39% of every health care dollar – over $18.7 billion in 2004 - we spend on administration. Cutting that number to just 37% of spending would save $1 billion.
  • Further savings from shifting care for the insured and uninsured alike from ERs to doctors’ offices – over 45% of ER visits in 2002 could have been treated in a doctor’s office or avoided if the patient had had adequate access to primary care.
  • New jobs, higher corporate profits, new tax revenues. The Urban Institute estimates that every dollar spent to expand coverage generates about $3.00 in economic and social benefits – as much as $1.7 billion depending on the number of Massachusetts uninsured.
  • Total – over $6 billion – $2.5 billion in existing spending and $3.5 billion in potential savings – to expand coverage and ensure timely, high-quality, cost-effective care for every resident. This estimate does not include additional savings or the value of social and economic benefits – which would cut costs by many additional billions of dollars.

Will my taxes go up?

  • This proposal does not require tax-based funding or that the state be the insurer.
  • Doing nothing is the same as a tax hike – it means less take home pay as premiums rise and larger out-of-pocket payments for the uninsured and self-insured and lower profitability and competitiveness for Massachusetts employers.
  • Between 2000 and 2004 workers, on average, faced a whopping hidden tax increase of 49.8% from their share of premium increases alone.
  • During the same time frame, employers, on average, faced a hidden tax increase of 30% cutting their profitability and investments in job creation and the innovation that makes the Massachusetts economy competitive.

Why a Constitutional Amendment?

  • Recent history offers a clear lesson: a purely legislative approach fails either because major reforms are repealed before full implementation, like the 1988 Universal Health Care Law, or suffer from funding cuts as in the 1996 public program expansions.
  • Laws enacted by the people, like Clean Elections and both tax cuts and tax increases have been repealed or ignored by the Legislature – something that can’t be done with a constitutional amendment ratified by the people at the ballot.
  • Similar language in our Constitution guaranteeing every child the right to a public education provided the people, the Legislature and stakeholders with the tools to leverage fundamental education and financing reforms and require their implementation.

Why use the ballot?

  • As health care costs skyrocket there has been a lot of debate but no action. It’s time to break the logjam.
  • When ratified, the people will have provided their elected officials with a clear mandate and the tools to move decisively, with stakeholder input, to design a system that works for everyone – patients, providers, employers and taxpayers.

What's the process?

  • The first two steps have already been successfully completed – the collection of 71,385 signatures from registered voters and the first 25% approval by the 2003-2004 Constitutional Convention.
  • The next step is a second approval by 25% of the 2005-2006 Constitutional Convention – a “yes” vote of 50 legislators.
  • The voters will have the final say in November 2006. If a majority votes to ratify, affordable coverage for all will become a constitutional guarantee in Massachusetts.









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