Physician and Patient Gains Made at 2003-2004 State House Session

The Massachusetts Legislature completed its "formal" sessions for 2003-2004 at about 2 a.m. on July 31 in a predictably chaotic crescendo of activity. Once the dust settled, it became clear that physicians and their patients made gains on Beacon Hill. However, more work needs to be done to curb soaring professional liability insurance rates and make Massachusetts a friendlier place for physicians to care for their patients.

This two-year session followed a typical legislative life cycle, beginning with optimism and a clean slate of bills filed and hearings held. Action slowed, however, mid-session when lawmakers fixated on the often-contentious budget process. Conversely, in the closing weeks, bills that had lain dormant for months took on new life, and the pace built to a frenzy as the closing date approached, with dozens of bills sent to the Governor for signature or veto.

Here's a scorecard of some of the key gains at the State House:

• Professional Liability: Although the Legislature did not pass comprehensive reform, it did take initial steps to address the problem. The fiscal year 2005 state budget cut the prejudgment interest rate in half and created a study commission to review the problem and report back on potential solutions by mid-December.
• Health Care Access: The FY 2005 budget also restored funding for the Children's Medical Security Plan, eliminating a waiting list of over 15,000 children seeking enrollment. It also provided increased funding for the Healthy Start initiative, a prenatal care program for low-income, pregnant women. Earlier in the year, the legislature established a commission to study health disparities and diversity in the health care workforce.
• Public Health: After years of cuts that reduced nonhospital Department of Public Health appropriations by about 35 percent, the Legislature increased funding this year for programs in school health services, immunizations, substance abuse, and tobacco control. In addition, the Legislature made Massachusetts the sixth state to ban smoking at all worksites.
• Public and Patient Safety: Last year, the state approved the use of "e-signatures," facilitating "e-prescribing" and the consequent reduction in medication errors. This year, it extended the state's ban on the sale of assault weapons -- a move made more critical by the apparent decision in the U.S. Congress to let the federal ban lapse.

The Legislature now moves into "informal" sessions through the end of the calendar year. During these meetings, legislation must be approved by unanimous consent, so the objection of a single lawmaker can preclude consideration. Gubernatorial overrides go unchallenged because overrides require a roll call, and roll call votes are prohibited during the "informal" sessions. Thus, most legislation approved between now and the end of the year will be uncontroversial. Nonetheless, the MMS will remain vigilant, particularly regarding efforts to extend the "scope of practice" of allied health professionals into areas now exclusively within the domain of physicians.

- Steve Shestakofsky

For further information on the fate of specific bills at this legislative session, please contact Steve Shestakofsky at sshestakofsky@mms.org.

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