Graham-Cassidy would be devastating for Mass.

Graham-Cassidy would be devastating for Mass.

Bill would gut CarePlus, which serves 300,000 residents

CHUCK IS A 58-YEAR-OLD MALE  with multiple chronic physical and mental health conditions, including diabetes, congestive heart failure, kidney disease, and depression. On top of his urgent medical needs – for which he frequently visits emergency services – he is chronically homeless. Chuck is a real person, one of nearly 2 million Massachusetts residents whose wellbeing will be directly jeopardized by the proposed Graham-Cassidy bill that remains alive in the US Senate.

As the largest health plan in the region serving all populations, regardless of age or life circumstance, our membership includes 200,000 people on Medicaid and more than 100,000 who receive subsidies to purchase individual insurance. We have a unique insight into just how devastating the health bill proposed by Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana would be here, not only to the most vulnerable among us, but also to our health system and society as a whole.  We join those voicing their strong opposition to this harmful bill.

As threatening as earlier efforts to replace the Affordable Care Act seemed to be for Massachusetts, the Graham-Cassidy legislation is markedly worse. By converting federal subsidies for important programs to massively reduced “block grants,” the measure would slash $800 million a year in Medicaid funding to Massachusetts for the decade to come, forcing the Commonwealth to cut programs and raising costs for employers and state taxpayers.

For example, it would completely wipe out CarePlus, Massachusetts’ expanded Medicaid program that covers individuals who are not eligible for standard MassHealth but can’t afford private market insurance. Currently around 300,000 Massachusetts residents rely on CarePlus for inpatient hospital services, behavioral health (mental health and substance abuse) services, and home health services.  It would also eliminate the subsidies that allow tens of thousands of other residents to receive health insurance coverage.

The bill’s impact would be felt across the Massachusetts health care ecosystem, as nursing homes and community health centers throughout the Commonwealth receive more than half of their total patient revenue from MassHealth. Community hospitals, which already see a disproportionate number of uninsured patients and depend on public payers for 60 percent of their gross revenue, would be at risk of failing.

Supporters of the Graham-Cassidy bill cite the same logic once put forth in President Ronald Reagan’s “New Federalism” – that relinquishing federal control of certain social programs would empower states to tailor programs and allocate funding more efficiently based on their populations’ particular needs. Unfortunately, that approach can only make sense if block grants accurately account for the cost of care for individuals in each state.

When the “block-granted” funding available for states such as Massachusetts gets slashed so deeply, our state legislators will bear the responsibility of closing the gap by reducing benefits, shrinking eligibility, and/or raising state taxes. This will impact everyone across the Commonwealth; not just those covered by Medicaid. Everything else in the state budget – from infrastructure upgrades to education to consumer protection – will face cuts.

We enacted the 2006 Massachusetts health reforms because of values we hold dear in this great state: innovation, collaboration, and equity. Businesses and bipartisan leaders on Beacon Hill also recognized that health care reform was not just the right thing to do morally – it has proven to be the right thing to do fiscally. Our economic competitiveness, booming growth, and strong record attracting new businesses to Massachusetts demonstrate the success of our health care reforms.

Meet the Author

Tom Croswell

President and CEO, Tufts Health Plan
Graham-Cassidy represents 20 years of hard work and progress potentially undone without careful consideration and debate.  We should all come together, overcome partisanship and polarization, reject this legislation decisively, and demand, for the health of our state and all its citizens, that we continue our long and positive move forward for health coverage.

Tom Croswell is the president & CEO of Tufts Health Plan.