"Strengthening the Health Safety Net Trust Fund" by Bruce Bullen

The state Division of Health Care Finance and Policy has issued draft regulations to strengthen this important piece of the health reform law.

The draft regulations reflect the dual mission of state-provided uncompensated care funding - to provide a temporary health care safety net for the uninsured and to function as a financing source for Commonwealth Care.

The goal of health reform is to insure as many people as possible, although a few will always be uninsured, if only for a short time. The Health Safety Net Trust Fund was established to assist the few remaining uninsured. Yet the state also promised the federal government that funds previously used for uncompensated care would be used in part to finance health reform programs. This means that there are fewer dollars available to fund free care and that these dollars must be spent responsibly if the larger financial plan is to work.

Luckily, the Division has recognized this dual purpose by aligning the Fund’s policies with those of the larger health reform system. The prudent eligibility, service, and provider payment policies contained in the regulations are consistent with the intent of the health reform law. The Fund’s predecessor, the Uncompensated Care Pool, actually undermined efforts to insure the uninsured by functioning as an attractive alternative to insurance. In contrast the proposed regulations enable the Health Safety Net Trust Fund to fulfill its mission without jeopardizing the financial viability of health reform.

The Division will be holding a public hearing on the proposed regulations on August 22nd. Many voices will be heard, and there will be suggestions made to weaken some of the provisions. It is important that everyone understand the dual purpose of the state’s uncompensated care funding and avoid weakening the health reform law.

Bruce Bullen, COO, Harvard Pilgrim Health Care