Legislators’ Support for a Right to Sue Health Plans in Massachusetts Eroding as Economy Declines

A softening economy and declining tax revenues have made some Massachusetts lawmakers "less inclined" to support legislation allowing patients to sue their health plans, the Worcester Telegram & Gazette reports. Instead, many lawmakers now appear focused on raising the state's cigarette tax as a means to increase funding for the state's "ailing" health care system (Sutner, Worcester Telegram & Gazette, 9/10). A state law that took effect Jan. 1 allows most patients in health plans to seek an external review, after first pursuing an appeal through their insurer's internal grievance process (Kaiser Daily Health Policy Report, 1/4). Support for broadening the law to include the right to sue insurers was high when the economy was doing well, but state tax receipts fell $35 million in August, or 3.1%, from last year, following a $38 million decline in July, leaving lawmakers to consider the economic ramifications of a right to sue. Such a law would not bring the state any additional revenues, and "critics" say it would likely lead to increased insurance costs. Richard Burke, spokesperson for the Fallon Community Health System, said, "It will directly impact the ability to provide quality health care at an affordable price. I don't think there's any question that it will increase the cost of health care in the state."

Competing Interests
Supporters of a right to sue, however, remain "undeterred," and Senate leaders have indicated that they will continue to press for passage of the law. But the Telegram & Gazette reports that the support for increasing the cigarette tax "appears broader" than creating a right to sue, even though Gov. Jane Swift (R) has promised to veto a tax increase. Backers of a tax increase say the additional revenue could be used to increase reimbursement rates to nursing homes and hospitals and to increase coverage for the uninsured. "There's been a lot of interest in the proposal before this, and I do think there's even more interest in it now," Marcia Hams, deputy director of Health Care for All, said, adding, "One of the main benefits will be to expand access to community health programs, and the tobacco tax itself will be a predictable means of lowering smoking rates." Critics of an increase, however, saying that making cigarettes more expensive would disproportionately affect low-income individuals (Worcester Telegram & Gazette, 9/10). For further information on state health policy in Massachusetts, visit State Health Facts Online.