Baker faces Medicaid conundrum

Is half a loaf better than none at all? Usually the answer is yes.

But Gov. Charlie Baker doesn’t seem so sure when it comes to his proposal to deal with ever-rising Medicaid costs in the state.

Baker laid out a plan in January that would have hit employers who don’t meet certain benchmarks for employee coverage with big assessments. After facing blistering opposition from business leaders, he came back with a revamped plan that lowered the hit to businesses and included a sweeping set of cost-cutting reforms of the state Medicaid program, known as MassHealth. The budget plan adopted last week by the Legislature includes the employer assessment, which would bring in about $200 million, but not the other program reforms Baker was seeking.

Yesterday, the governor was noncommittal when asked whether he would sign the assessment provision of the budget. “We’re going to keep talking,” he told reporters.

“I haven’t heard the Legislature say they’re opposed to this,” Baker said. “What I’ve heard them say is that they didn’t have much of a window here to process this. I grant that, but it took us awhile to get to the point where we finished our assignment and came up with a proposal that people in both the health care community and the business community could support, so it’s my hope that one way or another we’ll be able to implement the package.”

A coalition of business groups that supported Baker’s revamped plan says it strongly opposes the Legislature’s move to maintain the employer assessments while leaving out the program reforms. That potentially puts the Republican governor back in the bad graces of business groups that are his natural allies.

Health policy expert John McDonough wrote about the Baker proposal two weeks in CommonWealth, praising elements of the administration’s plan, but also raising a caution flag about the attempt to enact major changes in health coverage for poorer residents through the budget without any public hearings or chance for the proposals to be fully aired out.

Among other things, Baker’s proposal would shift 140,000 lower-income, non-disabled adults from MassHealth to the state ConnectorCare program, and also transfer 230,000 non-disabled parents and caretakers from MassHealth Standard to CarePlus, a plan for those who don’t qualify for standard Medicaid coverage.

“Because no open public process has been used, the Baker administration will get things wrong in spite of its best efforts,” wrote McDonough, who teaches at the Harvard Chan School of Public Health. “Altering health insurance coverage for 370,000 low-income citizens should not be a last-minute afterthought.”

A Boston Herald editorial says the Legislature’s health care approach — to hike fees on businesses without addressing the cause of those assessments  — makes no sense. And it chided Senate Ways and Means chairwoman Karen Spilka for throwing stones from her glass house. The reform proposals should go through “the proper process,” Spilka said.

The editorial called that “laughable excuse-making, from the same people who negotiated the final budget entirely in secret, and called for a vote less than six hours after releasing it to members.”

One thing is certain: Whether state leaders deal with them now or kick a can a little down the road, the MassHealth cost challenges aren’t going away.

–MICHAEL JONAS


BEACON HILL

As marijuana talks on Beacon Hill drag on, Marlboro Mayor Arthur Vigeant says it’s time for lawmakers to compromise and get a deal done so “we can deal with it.” (MetroWest Daily News)

A conservative immigration-policy think tank leader says says Gov. Charlie Baker seems “wishy washy” on the issue of Massachusetts becoming a so-called “sanctuary state.” (Boston Herald)

Alan Sisitsky, a former state senator from Springfield who clashed regularly with Senate President William Bulger, died Friday at age 75. Sisitsky once characterized the top-down Legislature as a place “dominated by deferential underlings who confer lavish praise on their leaders in exchange for additional office space, more prestigious committee assignments and the warm glow of collegial affection.” The more things change… (State House News)

MUNICIPAL MATTERS

Boston Mayor Marty Walsh is playing hardball with Ashkenazy Acquisition Corp., seeking better terms on its lease at Quincy Market that still has 57 years to run. (CommonWealth)

The Falmouth Board of Selectmen vote not to appeal a judge’s order shutting down the town’s two wind turbines, a decision that will end infighting in the community but cost about $14 million. (Cape Cod Times)

The Newton City Council takes it upon itself to approve a resolution calling for a federal probe of whether President Trump’s business dealings run afoul of the Constitution. (Boston Globe)

WASHINGTON/NATIONAL/INTERNATIONAL

Donald Trump Jr. was told ahead of a meeting with a Kremlin-connected Russian lawyer that the compromising information on Hillary Clinton that he was to be given was part of an effort by the Russian government to aid his father’s campaign. (New York Times) “It’s hard to tell whether the president’s son — apart from being duplicitous — is naïve, stupid, corrupt or all of the above,” says a Herald editorial. (Boston Herald)

Medicaid provision hits high-cost states such as Massachusetts the hardest. (Eagle-Tribune)

ELECTIONS

Despite progress in Lawrence, Mayor Daniel Rivera is facing a tough reelection fight. (Commonwealth)

Gentrification is a top issue in the race among 13 candidates for the Roxbury-based Boston district city council seat that Tito Jackson is vacating to run for mayor. (Boston Globe)

Maine Attorney General Janet Mills announces she will take on Gov. Paul LePage. (Governing)

BUSINESS/ECONOMY

Amazon announced it will bring 900 jobs to Boston at a new offices it will open along the Fort Point Channel. (Boston Globe)

The sale by Hingham’s Unitarian Church of its parish house is stirring development fears in the change-averse town. (Patriot Ledger)  

EDUCATION

Supporters of a downtown Lowell high school start gathering signatures to put a question on the ballot that would put the facility in the city’s core and not on the outskirts. (Lowell Sun)

One week into his new job, University of Massachusetts Dartmouth chancellor Robert Johnson talks about his vision for the campus. (Herald News)

HEALTH/HEALTH CARE

US Rep. Katherine Clark takes on Purdue Pharma, accusing the company of contributing to the opioid epidemic and trying to shame the firm into doing more to warn patients of the dangers. (CommonWealth)

A Lowell Sun editorial praises US Rep. Niki Tsongas for pushing legislation that would cut off fentanyl coming into the United States.

UMass Medical Center is facing a critical shortage of blood and is reaching out to the public for donors. (MassLive)

TRANSPORTATION

Delays at Logan Airport have eased now that a runway resurfacing project is done. (Boston Globe)

ENERGY/ENVIRONMENT

A bipartisan collection of South Shore pols are pressing Gov. Charlie Baker to oppose a proposed natural gas facility in Weymouth. (Boston Globe)

CRIMINAL JUSTICE/COURTS

MassLive digs into the large number of untested rape kits in Massachusetts.

A 26-year-old Brockton man who was shot to death early Monday became the city’s fifth homicide victim this year; the city recorded only two homicides in all of 2016. (The Enterprise)

Greater Boston takes the temperature of police-community relations in Roxbury after a spike in shootings in the city.

A man wielding several knives who was arrested out the Medford studios of KISS 108 was demanding that the station play “My Axe” by a the hip-hop duo Insane Clown Posse. (Boston Herald)

A Westport man who sued the town police department last year because he got injured slamming into a roadblock as he was fleeing a police pursuit was arrested again on multiple automobile-related charges. (Herald News)

MEDIA

The news business sinks ever closer to rock bottom. (The Atlantic)