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Massachusetts Question 5, Healthcare Council to Propose Comprehensive Coverage Legislation Initiative (2000)

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Massachusetts Question 5

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Election date

November 7, 2000

Topic
Administrative organization and Healthcare governance
Status

DefeatedDefeated

Type
Indirect initiated state statute
Origin

Citizens



Massachusetts Question 5 was on the ballot as an indirect initiated state statute in Massachusetts on November 7, 2000. It was defeated.

A “yes” vote supported creating a state Health Care Council to review and recommend legislation for a healthcare system providing comprehensive coverage to residents and prohibiting the conversion of nonprofit health care entities to for-profit status until such a system is in place.

A “no” vote opposed creating a state Health Care Council to review and recommend legislation for a healthcare system providing comprehensive coverage to residents and prohibiting the conversion of nonprofit health care entities to for-profit status until such a system is in place.


Election results

Massachusetts Question 5

Result Votes Percentage
Yes 1,229,652 48.12%

Defeated No

1,325,915 51.88%
Results are officially certified.
Source


Text of measure

Ballot title

The ballot title for Question 5 was as follows:

Do you approve of a law summarized below, on which no vote was taken by the Senate or the House of Representatives before May 3, 2000?

Ballot summary

The ballot summary for this measure was:

This proposed law would set up a state Health Care Council to review and recommend legislation for a health care system that ensures comprehensive, high quality health care coverage for all Massachusetts residents. Until the Council decided that such a system had been set up, the proposed law would prohibit the conversion of non-profit hospitals, health maintenance organizations (HMOs), and health insurance firms to for-profit status. The proposed law would also require health insurance carriers to provide certain rights to patients and health care professionals, starting January 1, 2001.

The Council would recommend laws to set up, and would decide whether laws had been passed to ensure, a health care system that provides:

• barrier-free access to health care services;

• patients' freedom to choose their health care providers, get second opinions, and appeal denials of care;

• health care professionals' freedom to act solely in the best interests of their patients;

• affordable coverage, with cost increases no greater than national averages;

• preserving and increasing the quality of care and encouraging research;

• at least 90% of all premiums to be used for patient care, public health, and training/research, and no more than 10% for administrative costs, with simpler paperwork and administration;

• a prohibition of financial incentives that limit patient access to health care, and limits on incentives for inappropriate care.

The Council would include 17 members representing health care and other organizations. It would hold public hearings, study proposals, and make recommendations to the state Commissioner of Public Health and the Legislature on laws and other steps needed to set up a system meeting the above requirements. The proposed law would also create a special legislative committee, including legislators and members of the Council, to make recommendations by September 30,2001, for laws to set up a system meeting the above requirements by July 1, 2002.

Starting January 1, 2001, the proposed law would require health insurance carriers to guarantee certain rights to their insured patients and to health care professionals. These rights would include;

• patients' right to choose all of their health care providers, subject to the approval of a freely chosen primary care provider who has no financial incentive to deny care, and subject to payment of a reasonable extra fee to see a provider outside the carrier's network;

• health care professionals' right to make medical decisions in consultation with the patients;

• patients' right to transitional insurance coverage when they are under going a course of treatment from a health care provider whose contract with a carrier is being terminated;

• patients' right to medically necessary referrals to specialists;

• limits on and disclosure of contracts between carriers and health care providers that create financial incentives to delay or limit care or provide inappropriate care;

• health care professionals' right to discuss health benefit plans with insured patients and to advocate on behalf of their patients;

• carriers could not terminate health care providers' contracts without cause;

• patients' right to receive emergency services, subject to authorization procedures, and to be reimbursed when they pay cash for emergency services from providers not affiliated with their carrier;

• utilization review procedures that meet specific standards, including patients' right to appeal to the Commissioner of Public Health;

• in any year at least 90% of a carrier's Massachusetts revenue must be spent on Massachusetts health care, and a carrier that spent more than 10% for non-health care purposes would have to refund the excess to its insured patients. Each carrier would have to report its revenues, premiums, and expenditures to the state Commissioner of Insurance every year.

The proposed law states that it would not interfere with any existing contract, including contract terms (such as automatic renewal or option clauses) that may go into effect after January 1, 2001. The proposed law states that if any of its parts were declared invalid, the rest of the law would stay in effect.

Full Text

The full text of this measure is available here.


Path to the ballot

See also: Signature requirements for ballot measures in Massachusetts

An indirect initiated state statute is a citizen-initiated ballot measure that amends state statute. There are nine (9) states that allow citizens to initiate indirect state statutes.

While a direct initiative is placed on the ballot once supporters file the required number of valid signatures, an indirect initiative is first presented to the state legislature. Legislators have a certain number of days, depending on the state, to adopt the initiative into law. Should legislators take no action or reject the initiative, the initiative is put on the ballot for voters to decide.

In Massachusetts, the number of signatures required for an indirect initiated state statute is equal to 3% of the votes cast in the last gubernatorial election. Massachusetts also has a distribution requirement that requires no more than 25% of the certified signatures on any petition can come from a single county.

The state Legislature has until the first Wednesday of May in the election year to pass the statute. If the legislature does not pass the proposed statute, proponents must collect a second round of signatures equal to 0.5% of the votes cast in the last gubernatorial election. The Legislature also has the power to place an alternative measure alongside the proposed statute via a simple majority vote of the state legislature.

A simple majority vote is required for voter approval. However, the number of affirmative votes cast for the measure must be greater than 30% of the votes cast in the election.

See also


External links

Footnotes