Let’s Start Treating Health Care as a Right

The following testimony was delivered to the Joint Committee on Health Care Financing on Tuesday, June 11, 2019.

Chairwoman Friedman, Chairwoman Benson, and members of the Joint Committee on Health Care Financing:

Thank you for holding this hearing today. My name is Jonathan Cohn, and I am the chair of the Issues Committee of Progressive Massachusetts. Progressive Massachusetts is a statewide grassroots advocacy organization devoted to shared prosperity, racial and social justice, good government and strong democracy, and environmental protection and sustainable infrastructure.

Medicare for All is a quintessential part of shared prosperity, and we are proud to support S.683 / H.1194: An Act establishing Medicare for All in Massachusetts.

Massachusetts has a storied role in the history of the fight for universal health care in the US. Our former senator Ted Kennedy was a longtime champion of single payer, and our 2006 health care reform law was a model for the Affordable Care Act nationally.

Although our health care reform law, boosted by the ACA, has helped Massachusetts achieve near-full universality in health insurance coverage, we still see underinsurance, high premiums, high rates of medical debt, and significant disparities—all inevitable outcomes of a reliance on private sector provision. Universal coverage alone doesn’t guarantee affordability, quality, or equity without additional steps.

These problems will continue to exist as long as we treat health care as a commodity instead of a right. The US remains the only advanced industrial country that has not recognized this as a fundamental right, but Massachusetts can lead the way.

A single payer system would save the Commonwealth money through increased efficiency; take the burden of rising health care costs off small businesses, municipalities, and families; eliminate medical debt and medical bankruptcy; and finally guarantee access to quality, affordable health care as a right for all residents of the Commonwealth.

Progressive Massachusetts also opposes H.1163: An Act establishing a special commission to study the implementation of single payer health care in the Commonwealth.

Although commissions can be a valuable tool in guiding policy decisions, the commission outlined in this bill would stack the deck against single payer by design. Past bills in the House, as well as S.674 (An Act to ensure effective health care cost control) in the Senate, would require the Center for Health Information and Analysis and the Health Policy Commission to do the necessary assessment work. The commission in H.1163 would still give space to CHIA and the HPC, but it would also include spots for the insurance lobby. That’s right: the bill would put a representative of Blue Cross Blue Shield and a representative of the Massachusetts Association of Health Plans in charge of determining whether or not Massachusetts should move toward a single payer system. The Massachusetts Health and Hospital Association would get a spot, too.

The hospital and insurance industries, of course, have spent large sums against Medicare for All nationally, and they are its biggest opponents here at home. We don’t need to fund a commission to know what the insurance industry and the hospital industry think about Medicare for All. You can google that.

Similarly concerning, H.1163 designates a spot for a “representative of employers,” but no representative for workers. And it includes no space for patients’ rights advocates.

The way we design our health care system has a significant impact on the lives of all residents of the Commonwealth, and putting equity and justice at the center of such a design is vital to ensuring that every person is able to live up to their full potential.

Sincerely,

Jonathan Cohn

Chair, Issues Committee

Progressive Massachusetts

“It is far past time for us to stop shortchanging our students.”

The following testimony was submitted to the Joint Committee on Higher Education.

Tuesday, April 30, 2019

Chairwoman Gobi, Chairman Roy, and Members of the Joint Higher Education Committee,

My name is Jonathan Cohn, and I am the chair of the Issues Committee of Progressive Massachusetts, a statewide multi-issue grassroots organization committed to fighting for social justice and progressive policy. Since our founding, treating education as a public good and funding it as such has been central to our mission.

As such, we strongly support S.744 / H.1221, An Act to guarantee debt-free public higher education, and S.741, An Act committing to higher education the resources to Insure a strong and healthy public higher education system (or CHERISH), and urge you to report them out favorably.

Since 2001, Massachusetts has cut funding for public higher education by 14 percent. However, at the same time that our state was retrenching from investing in our future, enrollment was going up. As a result, per student funding has fallen by 32 percent, almost a third.

When the state pulls back, the cost burden falls onto students. Massachusetts saw some of the highest tuition and fee increases in the country from 2001 to 2016, particularly during the recession. The share of costs borne by students and their families doubled, putting a degree out of reach for more and more students, especially those of disadvantaged backgrounds.

Today, the average graduate from our state universities and the UMass system leaves with over $30,000 in student debt—the tenth highest in the country. The average debt for graduates of public, four-year postsecondary schools grew faster in Massachusetts than in all but one other state from 2004 to 2016.

A postsecondary degree provides a proven premium in lifetime wages for graduates and countless other opportunities. Cost should not be a barrier. By preventing young people from living independently, buying a home, or pursuing their career of choice, college debt is a drag on our economy. Even when students drop out due to cost, they can be saddled with debt for years after.

It is far past time for us to stop shortchanging our students. Investing more in public higher education, as the CHERISH Act would require, and making public higher education debt-free would benefit not only students. When financial concerns are no longer a hindrance for people seeking to realize their full potential, we all benefit.

Time to End a Shameful History of Disenfranchisement

The following testimony was submitted to the Joint Election Laws Committee.

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Chairman Finegold, Chairman Lawn, and Members of the Joint Election Laws Committee,

As an organization committed to strengthening our democracy and promoting racial and social justice in our Commonwealth, Progressive Massachusetts strongly supports S.12, a proposal for a legislative amendment to the Constitution relative to voting rights and urges swift action.

In recent years, states around the US have started to realize that the decades-long phenomenon of mass incarceration was a moral, economic, and public safety failure. It destroyed communities, strained budgets, and made us no safer.

The omnibus criminal justice reform legislation passed last session to widespread public support shows that the MA House and Senate understand this. But there is more work to do.

The right to vote is a cornerstone of democracy. However, our neighbors in Maine and Vermont are the only states in the US to grant incarcerated individuals this right.

Massachusetts once did. However, in the late 1990s, Governor Paul Cellucci and other state politicians pushed to restrict this right, putting forth a constitutional amendment to prevent those convicted of a felony from voting while incarcerated.

Let us be clear. Given the inequities in our criminal justice system, this is part and parcel of our country’s shameful history of trying to disenfranchise minority voters. Although our state is only 7% Black, our prison population is 26% Black, and although our state is only 10% Latinx, our prison population is 24%. [1]

Moreover, the Supreme Court and US Congress have affirmed a variety of constitutional rights for prisoners. They have rights of religious freedom and a right to hold and express political opinions. As Supreme Court Justice Earl Warren once said, “Citizenship is not a right that expires upon misbehavior.”

Studies have repeatedly shown that maintaining a connection to the outside world is conducive to rehabilitation and reducing recidivism. [2] Allowing prisoners to participate in elections will strengthen their ties to the community, increase their sense of social responsibility, and facilitate their reintegration upon release.

We urge the committee to give this bill a favorable report.

[1] https://www.prisonpolicy.org/profiles/MA.html

[2] See, e.g., https://www.researchgate.net/publication/237298166_Inmate_Social_Ties_and_the_Transition_to_Society_Does_Visitation_Reduce_Recidivism.

“All It Took Was a Look at the Playground”

The following testimony was delivered to the Joint Committee on Education on Friday, March 22, 2019.

We are writing in support of the Promise Act. As retired special educators who also consulted with districts and families, we strongly support an end to the tiered educational system that exists in Massachusetts.

During five years of consulting to and in approximately 60 school districts, we found that all it took was a look at the playground to know what the educational quality would exist inside the school. Districts with fewer funds consistently needed to serve a wider range of student needs: for instance, higher rates of poverty and larger numbers of immigrants, which results in a greater number of traumatized students and a greater number of languages spoken. These districts are footing the bill for higher-income cities and towns that are unaffordable to immigrants and low income families. A culture of “not in my backyard“ has resulted in increasingly large educational gaps between the haves and have not‘s in Massachusetts.

The affluent cities and towns in our state, such as Needham, are able to raise additional funds through the educational foundation’s that have developed. This private funding is able to enrich the curriculum, provide playgrounds, and add back non-mandated services that may be lost by any reductions in state funds.

It is critical that more affluent communities acknowledge the burden taken on by other cities and towns that allow them more privilege and educational quality. It is time to level the playing field.

Thank you for consideration of our views.

Robert Vecchi, M.Ed.
Andrea Wizer, M.Ed.

Needham, MA

We Made a Promise to Our Students. We Need to Keep It.

The following testimony was submitted to the Joint Committee on Education on Friday, March 22, 2019.

Chairman Lewis, Chairwoman Peisch, and all the members of the Committee, 

My name is Jonathan Cohn, and I chair the Issues Committee at Progressive Massachusetts, a statewide, member-driven grassroots organization built from the ground up by organizers and activists from across the state to advocate for progressive policy. Other states routinely look to Massachusetts for direction, and it’s important for us to get things right.  

Quality public education for all is a central component of our platform, and no bill before the legislature better delivers on this promise than the PROMISE Act (S.238/H.586). 

Massachusetts is the birthplace of public education in the US, and our public schools routinely rank first in the nation because of high standardized test scores and postsecondary degree attainment rates. However, such high overall scores mask persistent inequities that continue to pose an obstacle to children’s ability to realize their full potential. The achievement gap between low-income and better-off students is one of the highest in the nation, as are disparities in per-pupil spending.  

A major source of this inequality lies in an outdated funding formula. The Foundation Budget, established in 1993 by the Education Reform Act, was intended as a starting point for funding school districts across the Commonwealth, based on the circumstances and needs of each student. Just like the hair styles and fashion of the early 1990s are out of date, so too are cost assumptions.  

The Foundation Budget is substantially lower than what all districts need, but only wealthy districts are able to make up for the funding shortfall. When the funding isn’t there, cuts to essential services and programs continue year after year. Communities are hamstrung by Proposition 2½ in their desire to fully provide for students’ education.  

The Legislature knows what needs to be done. The 2015 Foundation Budget Reform Commission outlined the path forward, issuing five co-equal recommendations related to transparency and tracking and four cost areas: special education, health care, English Language Learner education, and closing income-based achievement gaps. The PROMISE Act is the only bill before the Legislature that would fully implement all five recommendations, and it builds on such progress with important adjustments to make sure low-income students are properly counted and districts aren’t disproportionately impacted by the costs of charter school reimbursements.  

The other two bills under consideration fail to include adequate funding for low-income students. For example, whereas the PROMISE Act commits approximately $4,600/pupil per year in new achievement-gap-closure funding for our neediest students, the Governor’s bill promises only $473 when adjusted for inflation. These bills also fail to address the proper counting of low-income students and charter reimbursements. Now is not the time for partial solutions.  

It has taken the Legislature more than two decades to revise this formula. We owe it to students to stop punting and take bold and comprehensive action as quickly as possible.

Sincerely,

Jonathan Cohn

Achieving Liberty and Justice for All

The following letter was drafted by Caroline Bays and Jonathan Cohn from the PM Issues Committee and transmitted to the CJR conferees: 

House Chairwoman Claire Cronin, Joint Committee on the Judiciary

Senate Chairman William Brownsberger, Joint Committee on the Judiciary

Majority Leader Ronald Mariano

Chairwoman Cynthia Creem, Senate Committee on Bills in Third Reading

Ranking House Minority Member Sheila Harrington, Joint Committee on the Judiciary

Senate Minority Leader Bruce Tarr

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January 17, 2018

Dear Members of the House-Senate Conference Committee:

The Massachusetts incarceration rate, while low compared to other states, is three to four times higher than that of European countries. In fact, there are only seven countries with a higher incarceration rate than Massachusetts.

There has been a growing consensus that the policies of the “tough on crime” era were misguided. They did not make us safer, but instead entrenched lasting racial and economic inequities. Studies have shown that high levels of incarceration have devastating consequences for minority communities, including an increase in crime, poverty, and homelessness. They prevent individuals and communities from thriving and living up to their full potential and make cherished rhetoric of “liberty and justice for all” ring hollow.

We are grateful to the House and the Senate for their exhaustive work on Criminal Justice legislation. Both the House and Senate bills have many excellent provisions, and in the following letter, we identify (a) essential provisions in both bills that should be included in a final Conference report, (b) places where one bill or the other was superior and whose provisions merit inclusion, and (c) a few places where the bills stray from their intent. The subsequent recommendations will best help to achieve our mutual goal of ending mass incarceration in Massachusetts.

Mandatory Minimums

Mandatory minimum sentences remove judicial discretion in sentencing and treat every offender with the same blunt instrument, regardless of context. Mandatory minimums have succeeded spectacularly at fueling mass incarceration, but do not reduce crime. Our guiding goal is the elimination altogether of minimum mandatories, because of their abject failure to do what they purport to and their contribution to racist mass incarceration. Short of abolition, we advocate the reduction wherever possible of existing manmins, and rejection of any new ones.

Accordingly, Progressive Massachusetts urges the inclusion of the following:

  • All provisions that end mandatory minimum sentences, including the mandatory minimums for selling in a school zone which disproportionately impact minority communities
  • Higher thresholds to trigger a mandatory minimum sentence for trafficking in cocaine (Senate Sections 90-91),  or fentanyl or carfentanil (Senate Sections 92-96). The lower amounts are likely to result in long sentences for non-traffickers who are struggling addicts – a result contrary to the overall intent of both bills.      
  • Good time eligibility, i.e, Senate Section 343, which allows persons serving sentences for offenses that have been repealed by this legislation to begin earning good time as of the law’s effective date. Leaving the current law, which denies these prisoners all prospect of reintegration until they have served their mandatory minimum term, in place would perpetuate a destructive consequence of the war on drugs: indifference toward the prisoners on whom mandatory minimum sentences are selectively imposed (three-quarters of whom are members of racial or ethnic minorities) and to the communities to which they will eventually return.  Including Senate Section 343 in the conference report would further the recommendations of the Council on State Governments that we increase the capacity of prison programs aimed at reducing recidivism and create incentives for completing such programs.

Moreover, we urge you to reject the creation of any new mandatory minimum sentences, or the strengthening of those that exist. We applaud the House’s rejection of the amendment to impose 5 year mandatory minimum sentences for the distribution of a drug that results in the death of the user, as any increase in mandatory minimums is contrary to the purpose of ending mass incarceration. Increasing the number of drugs which will result in mandatory minimums as well as adding the brand new mandatory minimum for assaulting a police officer, a frequently abused charge, runs counter to the intent of returning the decision of justice back to the judges, where it belongs.

Fees and Fines

Excessive fees and fines criminalize poverty and warp the justice system, preventing us from delivering on the promise of “liberty and justice for all” and turning jails into debtors’ prisons.

Accordingly, Progressive Massachusetts urges the inclusion of the following:

  • Increasing so-called “fine time” from $30 per day to $90 per day and requiring appointment of counsel and determination of financial hardship before a court sentences a person to incarceration for failure to pay fines.
  • Abolition of parole fees (Senate Section 323) and the waiving of probation fees where a substantial financial hardship exists (Senate Sections 287-288).    
  • Additional provisions in both the House and Senate bills that allow for numerous other fees and fines to be waived upon a finding that the imposition of the fine would create a “substantial financial hardship”

Juvenile Justice

Involvement in the criminal justice system can be traumatic for children. Our policies should promote rehabilitation, especially for those most at risk. Successful reentry programs for youth bring community-wide benefits.

Accordingly, Progressive Massachusetts urges the inclusion of the following:

  • Reducing the time to seal juvenile records and allowing for expungement in order to improve youth outcomes upon re-entry
  • The exclusion of small children (under age 12) from delinquency proceedings
  • Raising the age of juvenile jurisdiction to include 18-year-olds
  • Creation of a civil infractions category of offenses for children and the decriminalization of certain low-level offenses for which adults would not be subject to incarceration
  • Establishment of a parent-child privilege to ensure children can talk freely to their parents (Senate §202)
  • The Senate’s “Romeo and Juliet” provision, which offers a sensible and limited exception to criminal prosecution for close-in-age youth who engage in consensual sexual activity
  • Provisions to reduce school-based arrests by ensuring schools and police set guidelines on school discipline and arrest
  • Limitations on solitary confinement of young people

Solitary Confinement

As a form of cruel and unusual punishment, solitary confinement runs counter to professed American values, and it can have irreparable damage on the individuals subject to it.

While we support the Senate version of the bill, we ask that some of the sections of the House version also be included in the final version. In particular, we urge the inclusion of the following:

  • Provisions to ensure that prisoners are transitioned out of segregation for a certain amount of time before they are scheduled to be released
  • Establishment of an oversight committee and corresponding data collection
  • The screening out of mentally impaired individuals from segregation
  • Access to out-of-cell programming and/or activities for a minimum of 2 hours a day at least 5 days a week

Miscellaneous

We also support the inclusion of the following key provisions in the final bill.  Adopting these policies will help to ensure that Massachusetts promotes just and humane treatment of all of our citizens.

  • Using the cost savings from reduced incarceration for community programs through a Justice Reinvestment Fund which will lower recidivism and benefit our entire community
  • Providing community-based sentencing alternatives for primary caretakers of dependent children who have been convicted of non-violent crimes
  • Resentencing those already imprisoned, using the new guidelines
  • Raising the felony threshold to $1500
  • Ending the punitive price gouging that telephone companies engage in which punish the families of inmates
  • Ensuring the safety and access to treatment for transgender inmates
  • Ensuring the rights of prisoners to have in-person visits

Our criminal justice system runs counter to our professed values, but it doesn’t have to. In the ensuing weeks, you will have the opportunity to pass a long-overdue overhaul of the system, enacting changes with far-reaching benefits to communities across the state. We hope that you embrace that opportunity.

Time to Reinvest in Public Higher Education

The following is testimony submitted to the Joint Committee on Higher Education for its hearing on July 13, 2017. Chairman Moore, Chairman Scibak, and members of the Joint Committee on Higher Education, I, Jonathan Cohn, Co-Chair of the Issues Committee of Progressive Massachusetts, am pleased to offer this testimony on behalf of Progressive Massachusetts. Progressive Massachusetts is a multi-issue, grassroots, member-based advocacy organization committed to an agenda of shared prosperity, racial and social justice, good governance and strong democracy, and sustainable infrastructure and environmental protection.  

Progressive Massachusetts would like to go on the record IN SUPPORT of bills H.633 and S.681.

Public higher education in the United States and especially in Massachusetts has played a critical role in expanding opportunity. A commitment to public higher education rests on an understanding that such institutions are anchors for the community, drivers of prosperity, producers of socially beneficial knowledge, and cultivators of forward-thinking individuals with skills and abilities that help them to succeed and us all to benefit. It’s quite simple: when public education in our Commonwealth is strong, we are all strong.However, since the early 2000s, we have been balancing the budget on the backs of students, with disastrous consequences.

Higher education has seen a 14 percent cut since 2001 despite substantial increases in enrollment. As a result, we are spending 31 percent less per student.

What does this mean in practice? Higher tuition and greater debt. Tuition now costs $4,000 more, on average, than it did in 2001. Three-fourths of students at public four-year colleges have to take out loans to afford their education, with their debt burden upon graduation more than 50 percent greater than it was at the start of the millennium.

Our chronic underinvestment in public higher education is preventing it from realizing its promise—and instead creating new roadblocks for working families across the state. Moreover, studies have shown that growing student loan debt has been a major drag on the economy, hurting us all.

Fortunately, it does not have to be this way. Bills like H.633 (free public higher education) and S.681 (debt-free higher education) offer a path forward.

Please Give a Favorable Report to H.633 and S.681.

Carbon Pricing: Keeping MA a Leader on Climate Action

The following was testimony submitted to the Joint Committee on Telecommunications, Utilities, and Energy on behalf of Progressive Massachusetts on June 20, 2017.

Chairman Barrett, Chairman Golden, and members of the Joint Committee on Telecommunications, Utilities, and Energy, I, Jonathan Cohn, Co-Chair of the Issues Committee of Progressive Massachusetts, am pleased to offer this testimony on behalf of Progressive Massachusetts. Progressive Massachusetts is a multi-issue, grassroots, member-based advocacy organization committed to an agenda of shared prosperity, racial and social justice, good governance and strong democracy, and sustainable infrastructure and environmental protection.  

Progressive Massachusetts would like to go on the record IN SUPPORT of bills H.1726 and S.1821.

As a coastal state, Massachusetts is especially vulnerable to climate change. To put it bluntly, we cannot achieve shared prosperity under water.Nine years ago, the Global Warming Solutions Act was signed into law, committing the state to reduce greenhouse gas emissions by 25% below the 1990 baseline in 2020 and by at least 80% in 2050. However, as advocates have often pointed out, and the Supreme Judicial Court ruled last year, Massachusetts is not on track to meet its own goals.

After President Trump moved to pull the United States out of the Paris Agreement, elected officials from both parties in Massachusetts condemned this misguided move and said that Massachusetts would continue to push forward with climate mitigation. But we need more than just rhetoric. We need concrete policies that enable us to realize and build upon our current commitments.

The carbon pricing bills under consideration—H. 1726 and S. 1821—are such policies. A 2014 study prepared for the Department of  Energy Resources found putting a price on carbon in a scheme akin to that of these bills “would reduce state GHG emissions to a larger degree than most other Massachusetts programs that currently operate for this purpose.” Indeed, it could reduce economy-wide emissions by 5-10%, with much of this reduction coming from the transportation sector, which is the largest source of emissions in Massachusetts.

The environmental benefits of such a pricing scheme are not limited to climate mitigation. The reduction in air pollution resulting from the price incentive could save over 300 lives over the next twenty years.

We are pleased that both H.1726 and S.1821 take important steps to counteract any potential regressive economic effects of a carbon pricing scheme, making sure that low-income residents are not bearing the burden of climate mitigation. And we specifically commend H.1726 for setting aside 20% of collected funds for a new Green Infrastructure Fund that would facilitate the decarbonization of the transportation sector and increase investments in renewable energy, energy efficiency, and climate resilience. Changing price incentives is just the first step in the critical task of mitigating climate change.

The situation at the federal level for climate policy ambitious enough to meet the challenges before us is grim. It has thus become increasingly important for states like Massachusetts to redouble their commitments. We must do so to avoid regress, and we must do so to provide models for national policies as our state so often has.

Automatic Voter Registration: We Have the Technology, What We Need Is the Will.

The following was testimony delivered before the Joint Committee on Election Laws on June 8, 2017, in favor of S.373/H.2091 (An Act Automatically Registering Eligible Voters and Enhancing Safeguards against Fraud) and S.371/H.2093 (An Act establishing Election Day registration).

Our democracy is strongest when everyone has the ability to participate, to make their voices heard. And one of the most fundamental ways citizens can engage in the democratic process is by voting.

Massachusetts prides itself in being a state routinely on the right side of history and a model for other states. However, when it comes to voting rights, we have often lagged behind our peers.

The 2014 election reform bill began the process of bringing our election administration into the twenty-first century by allowing online voter registration, pre-registration, and early voting, among other key reforms. It has been both popular and successful. And it is time to build on that progress. Automatic voter registration would do just that.

It increases the efficiency of election administration by integrating it seamlessly into standard government operations and by bringing Massachusetts into the Election Registration Information Center. It eliminates the need for constant re-registration when people move, and by digitizing the registration process, it can significantly cut down on the cost (and paperwork) involved, benefiting cities and towns. It improves the accuracy of the voter rolls. And it will reduce the number of eligible citizens who are left out of the democratic process—approximately 680,000 according to the US Census Bureau.

Two years ago, Oregon became the first state to adopt automatic voter registration. Since then, seven states and the District of Columbia (including our neighbors Connecticut and Vermont) have followed suit—with several more on the near horizon. And it has been a resounding success. According to a report from the Center for American Progress, Oregon’s bill increased voter registration, increased the number of actual people who voted, and made the voting population more representative of the state’s population.

I would also urge you to support H.2093/S.371, An Act establishing Election Day registration. States like Minnesota, Wisconsin, and our neighbor New Hampshire have had Election Day registration for decades, and it has helped to make sure that all eligible citizens can participate and have their votes counted.

We have the technology here in Massachusetts to embrace best practices and bring our elections into the twenty-first century. What we need is the will.

“We cannot have economic justice without reproductive justice”

JOINT COMMITTEE ON FINANCIAL SERVICES

TESTIMONY OF PROGRESSIVE MASSACHUSETTS IN SUPPORT OF S.499/H. 536 

An Act Relative to Advancing Contraception Coverage and Economic Security in our State

May 19, 2017

Chairman Eldridge, Chairman Michlewitz, and members of the Joint Committee on Financial Services, I, Jonathan Cohn, co-chair of the Progressive Massachusetts Issues Committee, am pleased to offer this testimony on behalf of Progressive Massachusetts. Progressive Massachusetts is committed to an agenda of shared prosperity and social justice that makes sure that our Commonwealth works for all residents. 

Progressive Massachusetts would like to go on the record IN SUPPORT of S. 499/H. 536, An Act Relative to Advancing Contraception Coverage and Economic Security in our State, or ACCESS.

Massachusetts has been a leader in health care reform, passing the legislation that would later become the foundation for the Patient Protection and Affordable Care Act. The ACA went beyond Massachusetts’s 2006 bill and brought about some of the greatest advances in health care access for women in a generation by eliminating co-pays and out-of-pocket expenses for basic preventive care, including contraception. The ACA guaranteed that women, regardless of their economic status, can afford birth control and can choose the birth control method that works best for them. 1.4 million women in Massachusetts now have access to preventive services like birth control with zero cost-sharing because of the ACA. However, the ACA and women’s health care in particular are under attack at the federal level. ACCESS is a vital piece of legislation to safeguard Massachusetts women from such attacks and to keep Massachusetts on the vanguard of health care reform. 

Progressive Massachusetts is committed to making Massachusetts a leader in protecting working families and expanding the middle class, while reducing poverty and inequality. And we cannot have economic justice without reproductive justice. Contraception enables women to decide if and when they want to start a family, time births, have healthier pregnancies, and achieve their desired family size. With contraception, women are better able to plan their educational, financial, and professional futures, ultimately improving their lives, the stability of their families, and the well-being of children. 

With the ACCESS bill, Massachusetts has an opportunity to build on the progress of the ACA. By establishing no-copay coverage for over-the-counter contraceptives, this bill will eliminate unnecessary financial barriers that undermine the accessibility of emergency contraception. The bill limits the ability of insurers to impose restrictions and delays in coverage and ensures medical decisions made by a woman and her doctor are respected. Moreover, by requiring coverage for a single dispensing of birth control intended to last for 12 months, this essential piece of legislation will decrease the likelihood of inconsistent use, and therefore unintended pregnancies, especially for those with limited access to transportation or pharmacies.

Massachusetts led the nation in health care reform, but the work is not done. It is time to be on the forefront again by proactively protecting and expanding access to basic, preventive health care. 

Please Give a Favorable Report to An Act Relative to Advancing Contraception Coverage and Economic Security in our State (S. 499/H. 536).