Major Accomplishments 2004-2006

The Massachusetts Legislature adopted An Act Providing Access to Affordable, Quality, Accountable Health Care, the first of its kind in the nation designed to ensure that virtually every person in the state has health insurance. 

• The new law requires all state residents to have health insurance by July 1, 2007. Those without coverage will face penalties unless a new agency, the Commonwealth Health Insurance Connector, determines that there are no affordable insurance plans available to residents at a particular income level. Already, approximately 60,000 low income residents have been exempted from the requirement.
• The state will pay the full cost of coverage for households below the federal poverty threshold, while those with household incomes between 100% and 300% of the federal poverty level will be eligible for state subsidies to help pay the cost of premiums. Residents with higher incomes must pay for coverage on their own.
• The Connector is responsible for setting standards for new insurance plans and for setting the level of state subsidy to make the plans affordable. Currently 42 plans are offered through 6 insurance companies with varying coverage options and deductibles.
• Massachusetts businesses with 11 or more workers that do not provide insurance must pay an annual fee of $295 per employee to offset the costs of health care for those employees.
• One provision of the law is designed to encourage healthier behavior by allowing health insurance companies to charge higher premiums for smokers and to provide discounts for those who complete weight loss programs or meet other wellness goals.

The Massachusetts Department of Public Health’s budget increased substantially for Fiscal Year 2007 after years of devastating cuts.

• The state public health budget for FY07 rose to $513.6 million, an increase of nearly $79 million compared to FY06 and its highest level in six years. The 18% increase included more than $40 million in supplemental funding approved as one-time measures, in addition to a 9% increase in “base” spending compared to FY06.
• Even with nearly $170 million restored to DPH, however, state public health funding, corrected for inflation, stands 15% lower than in FY01. 

The City of Boston and its many partners are collaborating to address the problem of health disparities.

• In June 2005, the Mayor's Task Force to Elimate Health Disparities —consisting of 23 industry and community leaders from hospitals, higher education institutions, community health centers and health coalitions—released a comprehensive data report and Blueprint of recommended actions.
• Partners HealthCare pledged $3 million to launch the Disparities Solutions Center at Massachusetts General Hospital.
• The Bay State Banner launched a monthly print and online supplement entitled “Be Healthy” to provide news and information on topics linked with racial and ethnic disparities in health.
• Recognizing the cutting-edge work of the Boston Public Health Commission’s Disparities Project,in 2006 the U.S. Department of Health and Human Services awarded Mayor Thomas M. Menino its national “Director’s Award,” which honors a government official “who has worked collaboratively and with singular purpose to improve minority health and eliminate health disparities.”

The Boston Public Health Commission, community health centers and a wide range of health, education and community agencies are implementing new programs to address obesity and diabetes.

• The Boston Public Health Commission established a Diabetes Prevention and Control Program in 2005.
• During the summer of 2006, more than 1,700 Bostonians spent 30-60 minutes participating in weekly and often daily walking groups sponsored by community agencies in eight neighborhoods.
• The Boston BestBites campaign began working with neighborhood restaurants to develop or highlight healthier, lighter menu options as part of the City’s strategy to fight obesity.
• Five community health centers in communities with high rates of diabetes received funding from the Richard and Susan Smith Family Foundation and the Paul and Phyllis Fireman Charitable Foundation to improve the quality of care they provide to patients suffering from diabetes, using intensive case management, diet and lifestyle coaching, and community outreach programs.

Boston’s comprehensive public health network and initiatives have achieved major progress, despite funding obstacles.

• Boston’s teen birth rate continues to decline, with the proportion of teen births to young women who were already mothers falling from 23% in 1990 to 13.5% in 2004, the 2^nd best proportion of repeat teen births among the 50 largest cities in the US (See Indicator 7.1.2).
• Rates of self-reported maternal smoking during pregnancy dropped from 4.5% in 2002 to 3.6% in 2004, raising Boston’s rank among the 50 largest cities to 8^th best and continuing a decade-long decline from 19% (See Indicator 7.1.2).
• HIV/AIDS incidence rates (new cases per 100,000 population) have continued to decline, with the 2005 rate at the lowest level in a decade and 65% lower than the rate for 1995. AIDS incidence rates have been declining over time, largely due to the effectiveness of newer HIV treatment regimens that slow the progression of HIV infection to AIDS (See Indicator 7.3.3).
• Elevated blood lead levels among Boston children declined by more than 50%from 2001 to 2006, continuing a long decline from 42% of children under six with elevated blood lead levels in 1990 to only 2% in 2006 (See Indicator 7.7.1).
• Infant mortality rates declined by 42% from 1992 to 2004, from 10.3 deaths per 100,000 births to only 6.0 in 2004. However, the infant mortality rate among black Bostonians remains twice as high as the rate for Bostonians as a whole (See Indicator 7.4.1).

Greater Boston added two more Nobel Prize winners in life sciences to the twelve area researchers who received biology, chemistry or medicine Nobel Prizes between 1980 and 2002.

• Craig Mello, a professor and researcher at the University of Massachusetts Medical School in Worcester, shared the 2006 Nobel prize in medicine for the discovery of RNA interference or “gene silencing.”
• MIT’s Richard Schrock shared the 2005 Nobel in chemistry for the discovery of a chemical reaction used for the more efficient and environmentally friendly production of pharmaceuticals and many other products. 

Massachusetts enacted legislation that will help prevent AIDS and hepatitis C by allowing over-the-counter sales of clean needles to adults without a prescription. Massachusetts joined 47 other states with similar policies after public health advocates overwhelmed stubborn opposition by opponents who claimed the measure would encourage drug addiction. 

The Alliance for a Healthy Tomorrow—a coalition of health, labor, religious and environmental organizations—led the effort to enact statewide legislation designed to reduce exposure to mercury. The law will phase out the use of mercury in products where alternatives exist and require manufacturers to take back mercury-containing devices.