Baker plays budget man in the middle

It’s become a well-known part of the current dynamic on Beacon Hill: Though Democrats enjoy super-majorities in both legislative branches, the House leans right and often forms a tag-team with Republican Gov. Charlie Baker that isolates the more liberal Senate.

With the 2018 budget plan put out yesterday, however, House leaders don’t just lean right, they move right past Baker and have the governor looking like a wild-eyed tax-and-spender.

The most controversial issue in the budget debate is likely to be an effort by the Baker administration to rein in Medicaid costs — now gobbling up 40 percent of the state budget — by levying an assessment on employers whose health care plans don’t meet a set of requirements. The administration says too many people with workplace-based insurance are moving onto the Medicaid rolls, a trend that is crowding out the state’s ability to meet other spending needs. The administration’s assessment on employers would generate an estimated $300 million a year. The administration is also looking to slow overall health care costs by limiting insurance reimbursement increases at the state’s most expensive hospitals.

The tax on employers has drawn fierce opposition from the business community, opening up an unusual rift between its leaders and the generally business-friendly governor. The House plan pulls back on the employer levy — and also nixes the hospital price limits — but there are differing takes on just how much of a retreat the proposal represents.

The Globe says the House budget “significantly tempered two controversial proposals” by Baker. The House would maintain a fee on employers, but wants it to apply more narrowly and estimates such a scheme would generate $180 million, nearly half the administration estimate. “It’s clearly a step in the right direction,” Jim Rooney, head of the Greater Boston Chamber of Commerce, tells the Globe.

The Herald paints the picture differently. “Miffed business leaders say that House leaders have essentially kept alive Gov. Charlie Baker’s proposal to hit companies with a health insurance tax as part of their $40.3 billion budget proposal, which calls for more dialogue — but no concrete alternatives — to the controversial plan,” writes Matt Stout.

The House essentially seems to tell Baker it’s OK to levy an employer assessment of some kind, but let’s have it bring in only $180 million, not $300 million, and you figure out the details.

“We obviously can’t continue to go down this path,” Speaker Robert DeLeo said of soaring Medicaid costs, but he and his underlings have punted on specifics of an alternative, more sustainable path to follow.

“We’re cautiously optimistic that a constructive dialogue will continue between the administration and the business community that will yield a better outcome,” said House Ways and Means Chairman Brian Dempsey. That’s Beacon Hill talk for, we have a ways to go before this thing is settled.  

Jon Hurst, of the Retailers Association of Massachusetts, makes clear how the business community views the problem. “We firmly believe health care costs in this state are out of control,” Hurst tells the Herald. But offering the sort of Republican budget-talking-point one expects from Baker, he added, we have to “question whether this is really a revenue problem or an expenditure problem.”

That would seem to be encouraging cuts in Medicaid services and spending — which is obviously easier for Hurst to suggest than Baker.

Between the employer assessment — which the governor says is open to negotiation — and the proposal to limit reimbursement rate increases for the highest-cost hospitals, Baker’s moves seem more drawn from the Democratic playbook than the free-market thinking he is usually associated with. (The talk of capping prices is a far cry from the days in the early 1990s when Baker was part of the Weld administration effort to unwind hospital price-setting as part of the deregulation of health care.)  

When it comes to the big health care questions, at least, Baker seems to be landing between the Democratic House and Senate, a feat that more than earns him the moniker of moderate Republican — and is probably not unrelated to the sky-high approval rating he continues to record.

–MICHAEL JONAS


BEACON HILL

Lawmakers say a state formula miscalculates education costs by $1 billion. (Herald News)

Gov. Charlie Baker proposes that poor defendants do public service rather than “fine time.” (MassLive)

A new Morning Consult poll puts Baker back on top as the nation’s most popular governor, with 75 percent of Massachusetts voters approving of the job he’s doing. (Boston Globe)  

MUNICIPAL MATTERS

The view from $10 million up. What the urban luxury invasion of Downtown Crossing means for Boston. (CommonWealth)

New Bedford City Council Kerry Winterson says he was molested when he was 13. (South Coast Today)

South Boston residents speak out against a proposal to tear down a single-family house and replace it with five condos. (Boston Herald)

In Peabody, hackles get raised by officials and advocates for marijuana dispensaries over a plan to create a special area zoned for pot. (Salem News)

New Bedford Mayor Jon Mitchell announces a plan to spend more than $5 million sprucing up the Elm Street Parking Garage. The money will come from an enterprise fund set up in 2015, not from taxpayers. (South Coast Today)

WASHINGTON/NATIONAL/INTERNATIONAL

Alabama Gov. Robert Bentley resigns amid affair scandal. (Time)

The Globe gets hold of Mitt Romney’s famous “binders full of women.”

ELECTIONS

Jay Gonzalez has hired Kevin Ready, who served a political director on Martha Coakley’s losing run for governor in 2014, to manage his Democratic bid for governor next year. (Boston Globe)

BUSINESS/ECONOMY

Attorney General Maura Healey travels to Pittsfield to decry a big rate hike requested by Eversource in western Massachusetts. (Berkshire Eagle)

Quite a surprise. Housekeeping finds a 5-foot ball python in a hotel room drawer in Worcester. (Telegram & Gazette)

EDUCATION

Massachusetts voc-tech schools are a big success, but are they shutting out students who might need them the most? (CommonWealth)

Joan Vennochi says UMass Boston is loading up on politically-connected new hires and consultants and building out dorms at a time when higher education is moving away from costly residential models — all against the backdrop of the controversial ouster of Chancellor Keith Motley. (Boston Globe) Sen. Linda Forry says Motley is the victim of a “smear campaign” as the fall guy for financial problems that university trustees and President Marty Meehan also bear responsibility for. (Boston Herald) Gov. Charlie Baker says he wants answers. (WGBH) Harvey Silverglate blames administrative bloat. (WGBH)

HEALTH/HEALTH CARE

The opioid crisis is creating a need for more foster families willing to care for children whose parents are undergoing addiction treatment. (The Enterprise)

A for-profit, 120-bed psychiatric hospital is planned for Worcester. (Telegram & Gazette) Edward M. Murphy wrote about the booming market for psychiatric beds, much of it occurring without the typical level of government coordination. (CommonWealth)

Sen. Elizabeth Warren is part of a bipartisan effort to make it easier and cheaper to get hearing aids — but audiologists are pushing back. (Boston Globe)

TRANSPORTATION

The MBTA unveils controversial, last-minute cost savings proposals. (CommonWealth)

The T lays out what some are calling a “rescue plan” for commuter rail. (CommonWealth)

The T estimates the Green Line Extension will run a net operating deficit of $23 million a year. (CommonWealth)

The replacing of a Commonwealth Avenue bridge in Boston this summer will have ripple effects that may make for a major traffic and transportation mess for several weeks. (Boston Globe) Here’s CommonWealth’s report on the two-part, accelerated bridge replacement.

Other states are now looking to follow suit and vet Uber and Lyft drivers more thoroughly after a Massachusetts review found more than 8,000 drivers with disqualifying backgrounds after they had passed the company’s internal reviews. (Boston Globe)

One of the officers who dragged a man off an overbooked United Airlines flight is placed on leave. (Time)

A couple stepped out of an Uber at a Quincy convenience store and the driver took off with their 9-month-old son in the backseat, the result of a miscommunication that was resolved and parents and the baby were safely reunited. (Patriot Ledger)

CASINOS

Twin River Worldwide Holdings is doing site prep and seeking regulatory approvals for a casino in Tiverton, Rhode Island, just across the Massachusetts border from Fall River. Rhode Island voters gave Twin River to transfer its license from Newport Grand to Tiverton. (Herald News)

MEDIA

The Pulitzer Prize winners and their stories.

  • Mhmjjj2012

    How about publicly identifying the companies whose employees do not participate in their workplace-based insurance plans and instead choose Medicaid?