Budget notes: Beacon Hill assuming Encore will open on time

Nursing homes get $30m Band-Aid

THE MASSACHUSETTS GAMING Commission is currently meeting in private, trying to decide whether Wynn Resorts should be allowed to retain its casino license and open on time in June. But budget officials on Beacon Hill are acting as if the decision has already been made.

A fiscal 2020 budget proposal put out by the House Ways and Means Committee on Wednesday counts on $98 million in state tax revenue from the Encore Boston Harbor facility in Everett.

A spokesman for Rep. Aaron Michlewitz of Boston, the chair of the Ways and Means Committee, said the House is following the lead of what the governor did in his budget.

In response to questions about other potential revenue sources not included in his budget proposal, Michlewitz said he was trying to be conservative. “We were trying to build our budget based off the revenues we currently have in front of us,” he said.

$30 million Band-Aid for nursing homes

The House Ways and Means budget proposes a $30 million increase in state spending on nursing homes and also calls for the creation of an “emergency task force” that would recommend ways to bring stability to the industry.

The nursing home industry says 20 facilities closed last year and more than 30 are in danger of going out of business this year. A key part of the problem is that state officials set rates using cost benchmarks from 2007. CHECK IT OUT: A story and a Codcast on the nursing home situation from early March.

At a hearing earlier this week, industry officials testified in support of a number of bills that would provide additional aid to the industry. House leaders, however, seem inclined to put a $30 million Band-Aid on the problem while a task force spends a year proposing longer-term solutions.

Biz-friendly House backs drug price-setting

The business-friendly House isn’t riding to the rescue of the state’s life sciences industry – its budget plan for fiscal 2020 sides with Gov. Charlie Baker in allowing MassHealth to negotiate drug prices directly with manufacturers and, if that effort fails, put them through a rate-setting process.

Robert Coughlin, president and CEO of MassBio, issued a statement suggesting the House Ways and Means budget proposal would be a disaster for an industry that plays a key role in the Massachusetts economy.

“If passed, it would rapidly change the face of biotech innovation, scare away investors, and immediately harm patients who are awaiting the next treatment or cure of their disease,” he said.

The House plan mirrors the governor’s budget proposal on drug pricing. It would allow MassHealth to negotiate more favorable pricing directly with the drug manufacturer. If that effort fails, state officials could move forward with a rate-setting process. If the manufacturer refuses to comply with the outcome of that process, the firm could be referred to the Health Policy Commission, which could hold a public hearing on the manufacturer’s pricing approach. This latter step would come into play only for drugs that cost at least $25,000 per person per year or $10 million in the aggregate annually.

The House proposal did not include a provision in the governor’s budget calling for uncooperative manufacturers to be referred to the attorney general for prosecution under state consumer protection laws. Rep. Aaron Michlewitz of Boston, the chair of the House Ways and Means Committee, said the provision wasn’t needed because the attorney general already has the authority to prosecute.

The House language also spells out what state officials would consider in determining a price for a drug – clinical efficacy and outcomes; publicly available information on the drug’s pricing, including prices paid by other developed nations; the drug’s public health value; utililization of the drug; the likelihood the drug will reduce the need for other medical care; pricing analysis by independent third parties; and the number of manufacturers that produce the drug.

Medicare savings changes

The House Ways and Means budget would alter the eligibility for the Medicare savings program, opening it up to 25,000 more people at an estimated cost of $4 million in fiscal 2020.

For the purpose of determining eligibility, the change would disregard 30 percent of income for seniors who are otherwise eligible.

“This will provide provisions of Medicare newly available to 25,000 low-income seniors,” Michlewitz told reporters.

CHECK IT OUT: A story on seniors worried about losing out on Medicare savings plan coverage from January.

Reproductive health

The House Ways and Means budget would make two big changes targeted at women’s reproductive health.

The bill would spend $500,000 on an effort by the Health Policy Commission, the Betsy Lehman Center and the Department of Public Health to reduce pregnancy-related deaths. The commission would run a two-year pilot, collect data, and report back to the Legislature.

Additionally, the budget bill would direct the Department of Public Health to promote awareness of reproductive health care facilities. The department would also be tasked with analyzing any changes to the availability of reproductive health services.

The clinic promotion policy rider is a companion to legislation Gov. Charlie Baker recently signed into law that backstops $8 million in funding for local clinics who may lose access to federal funds because of a Trump administration rule limiting funding for clinics that provide abortions.

Restaurant Promotion

One area of focus for the House Ways and Means Committee is the Bay State’s restaurants. The budget bill would create an 11-member Restaurant Promotion Commission, which among other endeavors would recommend how to spend $2 million in funding overseen by the Massachusetts Office of Travel and Tourism.

The commission would look into barriers that aspiring restaurateurs face, licensing issues, and the possibilities for cross-promotional partnerships. It would need to submit its findings by Jan. 31, 2020.