Lawmakers reject Baker’s MassHealth cuts
Legislature says it will come up with a Medicaid savings plan
STATE HOUSE NEWS SERVICE
HOUSE AND SENATE DEMOCRATS, insisting they needed more time to consider strategies to control cost growth in MassHealth and the broader health care system, turned aside Gov. Charlie Baker’s proposed Medicaid reforms on Wednesday as they worked to return to him a $200 million assessment on employers needed to balance the budget.
Baker and major business groups have been insisting that the new employer fees to pay for growth in the MassHealth program be packaged with longer-term cost saving measures, including a shift of 140,000 low-income residents from Medicaid to subsidized commercial plans offered through the Connector.
Legislative leaders, however, have balked at rushing to accept a proposal that Baker offered in June and which would impact coverage for thousands of low-income families without fully exploring the potential impacts and alternatives to save money.
The House rejected the governor’s budget amendment 41-116, with seven Democrats joining all but one Republican in supporting the governor’s plan. The Senate followed suit on a party-line vote of 6-31. One more vote is required in the Senate to return the budget sections without MassHealth reform to Baker.
Baker will have to choose whether to accept the employer assessments without reforming MassHealth and risk alienating the business community, or veto the assessments. The assessments are accompanied by a proposal to slow planned increases in unemployment insurance rates paid by businesses, saving employers $334 million over the next two years.
“At the Legislature’s request, the administration presented lawmakers with a comprehensive package that ensures quality health care coverage for residents, addresses the health care safety net’s fiscal sustainability over time while protecting taxpayers from having to pick up the bill for more individuals’ health care, and the administration looks forward to continuing to work collaboratively on solutions,” Baker press secretary Lizzy Guyton said in a statement.
The governor’s office would not comment on whether Baker planned to veto the employer assessment, which would require a two-thirds vote in both branches to override. Baker previously called for action on his full proposal by mid-September, or he warned he would have to take other corrective action to balance the budget.
Health and Human Services Secretary Marylou Sudders on Tuesday floated the idea of across-the-board cuts to rates paid by MassHealth to providers if enrollment reforms were not passed.
Sanchez said the House remains committed to identifying saving and reforms “through the legislative process as the deliberative body that we are,” while Senate President Stanley Rosenberg’s office on Wednesday night outlined a process to produce a bill by the early fall.
The Senate, meanwhile, held a private caucus on Wednesday where many of the same players in the health care field that testified publicly on Tuesday at a joint hearing spoke to senators.
Senate Ways and Means Chairwoman Karen Spilka said she was “dismayed” when Baker sent the employer assessment and UI rate changes back to the Legislature as an amendment to “hold a balanced budget hostage” in order to secure MassHealth reform.
“We will never be able to collect what the governor says is collectible unless we pass it now,” Spilka said. The Ashland Democrat said an “earnest review” of the governor’s reform plan was underway, but added that the administration does not have “a monopoly on the ideas that are out there on health care.”
Sanchez and Spilka convened a hearing at the request of Gov. Baker on Tuesday to take testimony on the governor’s proposals, but many legislators and health advocates over the course of several hours expressed concern.
“One thing that was abundantly clear from yesterday’s testimony is that there’s considerable uncertainty about the effect that this plan will have on low-income individuals, as well as the elderly and disabled,” Sanchez said.
Senate Minority Leader Bruce Tarr expressed his own concern that if the Legislature accepts the money in the form of employer assessments now it may never return to cost control. He suggested taking a “timeout” for a few days or passing a resolution to consider MassHealth at a future date certain.
“The only option that’s not acceptable is to do nothing, take the short-term solution and hope it gets better,” Tarr said.
Sen. Vinny deMaceco, the ranking Republican on the Senate Ways and Means Committee, defended Baker’s proposal as a “humane and responsible approach” to a Medicaid spending problem that he said was crowding out investments in other priorities.
He noted testimony from Sudders on Tuesday that “not a single person” would lose coverage, and low-income families would continue to have access to zero-premium health plans.
“We all know at the national level there is a battle going on there as well and we have to be proactive in addressing our costs now so if something changes we are in a better position to address those changes and we don’t have a catastrophic drop all at once,” deMacedo said.
A similar debate played out in the House where House Minority Leader Brad Jones described the actions being taken by lawmakers as pulling out one leg of a three-legged stool that included health care fees, a reduction in unemployment insurance rate hikes and MassHealth reforms.
Jones’ amendment to proceed with the unemployment insurance rate relief immediately and hold off on the employer assessments was defeated 41-116.Massachusetts Democratic Party Chairman Gus Bickford applauded the defeat of Baker’s amendment.
“Taking Medicaid away from working families won’t do anything to reduce the overall cost of health care; it’s just a budgeting maneuver that puts the costs on hard-working families who are already struggling to make ends meet,” he said. “Governor Baker and his fellow Republicans should end their attempt to take away Medicaid from working families, and work with Democrats on real bipartisan reforms that actually reduce the cost of health care, like cracking down on prescription drug pricing and investing in addiction prevention and recovery.”