Baker facing resistance to MassHealth cuts

In Washington, the fight over the nation’s health care future is full of drama. Sen. John McCain of Arizona, who is dealing with brain cancer, vowed to return to Capitol Hill today to vote on whether to begin debate on repealing the Affordable Care Act. And President Trump is making it very clear where he stands on repeal.

“The question for every senator, Democrat or Republican, is whether they will side with Obamacare’s architects, which have been so destructive to our country, or with its forgotten victims,” Trump said. “Any senator who votes against starting debate is telling America that you are fine with the Obamacare nightmare.”

Massachusetts is having its own health care debate. It’s not as dramatic as what’s taking place in Washington and it’s certainly a lot narrower in scope and impact. But it’s one of those rare instances when Gov. Charlie Baker is facing real political opposition to his efforts to rein in spending on MassHealth.

In passing the fiscal 2018 budget, lawmakers approved $200 million in health care fees sought by Baker but refused to go along with his call for cuts in MassHealth spending. Baker responded by sending the cuts back to the Legislature for action, prompting a series of hearings today on Beacon Hill. Baker has strong support in the business community, but he is facing resistance from those who say he is scaling back the state’s commitment to universal health care coverage. The debate has played out over the last few days in a series of opinion pieces in CommonWealth magazine.

Three Democratic state reps — Christine Barber of Somerville, Ruth Balser of Newton, and Jay Livingstone of Boston — accused Baker of trying to have it both ways by criticizing Trump’s efforts to repeal the Affordable Care Act in Washington while pushing for changes locally that would roll back Medicaid expansion authorized by the act. “Balancing the budget is an extremely difficult task in this environment, but should not be done on the backs of the working poor,” they said.

Michael Widmer, a member of the board of the Massachusetts Health and Hospital Association and a former president of the Massachusetts Taxpayers Foundation, was also critical of the Baker administration. He said Baker’s proposals need much more study and there’s no rush to pass them because Medicaid enrollment is going down, not up.

The Baker administration and its allies quickly responded. Marylou Sudders, the governor’s secretary of health and human services, said Baker’s reform package “is a step towards preserving universal coverage, not a step away from it.”

Sudders said “critics say that our reform package is not needed because MassHealth enrollment growth has begun to slow, we should wait for Congressional action, and that we are not committed to health care coverage. None are true.” She did not elaborate in her article on Widmer’s claim that MassHealth enrollment is slowing.

Meanwhile, three business leaders — Chris Carlozzi of the National Federation of Independent Businesses, Jon Hurst of the Massachusetts Retailers Association, and Bob Luz of the Massachusetts Restaurant Association — sided with Baker, saying it’s time to get the MassHealth house in order. They singled out Baker’s call for moving people above the federal poverty level off of MassHealth.

“For those above the poverty line, we must ask ourselves if taxpayers can continue to afford to keep paying for improper incentives and guardrails, and rising provider expenses which far exceed the growth in our economy,” they said.



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The New York Times has an explainer on today’s health care doings in the US Senate.

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