For Mass., high stakes in health debate

Efforts to repeal the Affordable Care Act gained some momentum this week as Republicans put forward legislation that would put the brakes on federal health care spending in a way that would disproportionately impact blue states such as Massachusetts, New York, and California.

The legislation, filed by Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, has two key elements. It would give each state a block grant for health care and health insurance each year from 2020 to 2026. It would also make deep cuts in the Medicaid program. Instead of an entitlement program designed to provide health insurance for the poor and disabled, the Graham-Cassidy bill would put Medicaid on a budget and give states a per-beneficiary allotment of federal funds.

The proposal appeals to Republicans concerned that the federal government has become an open checkbook when it comes to health care spending. The bill would begin to rein in federal health care expenditures, and particularly spending on Medicaid, while giving states much more flexibility in determining how to use the money they do receive. States would receive the block grant funds without putting up any of their own money.

Most of the news coverage so far has focused on the big picture – how many people will lose health care coverage and the impact on people with pre-existing conditions. Pressure is building for a quick vote because only days remain before the expiration of special parliamentary language that protects repeal legislation from a filibuster in the Senate, and all eyes are on the key swing votes. Where does Sen. Susan Collins of Maine stand on the new bill and how will Sen. John McCain of Arizona vote now that the governor of his state has come out in support of the Graham-Cassidy legislation?

But there also seems to be an element of political payback in the discussion going on in Washington. “Right now, 37 percent of the revenue from the Affordable Care Act goes to Americans in four states. That is frankly not fair,” said Cassidy. The four states are California, New York, Massachusetts, and Maryland, according to the New York Times.

An analysis by the Center on Budget and Policy Priorities, a left-leaning think tank, indicated the bill over time “would punish states that have adopted the Medicaid expansion or been more successful at enrolling low- and moderate-income people in marketplace coverage under the ACA.” It would impose lesser cuts or even raise funding initially for states that did the opposite.

By 2026, according to the Center on Budget and Policy Priorities analysis, the 20 states facing the largest funding cuts in percentage terms under the Graham-Cassidy bill would be Alaska, California, Connecticut, Delaware, the District of Columbia, Hawaii, Kentucky, Louisiana, Maryland, Massachusetts, Minnesota, Montana, New Hampshire, New Jersey, New York, North Dakota, Oregon, Rhode Island, Vermont, and Washington.

In dollar terms, Massachusetts stands to lose an estimated $5.1 billion in federal funding by 2026 under the Graham-Cassidy bill, according to the analysis by the Center on Budget and Policy Priorities.

BRUCE MOHL


BEACON HILL

Lawmakers are revisiting a plan to tax short-term rentals. (Gloucester Times)

MUNICIPAL MATTERS

Mayor Marty Walsh says Boston won’t publicly release its bid for the new Amazon headquarters before the October 19 submission deadline. (Boston Herald)

The Worcester City Council is preparing to vote on a proposal to exempt from taxation any improvements made to a home to provide housing for a senior citizen related to the owner. (Telegram & Gazette)

A Quincy city councilor wants to hold hearings on the job performance of the city’s animal control officer, who she says constantly takes too long to respond to calls, including a recent incident in which an elderly woman was bitten by a dog. (Patriot Ledger)

The Boston area’s five major sports franchises plan to launch a joint campaign to combat racism in the wake of several racially-charged incidents this summer at Fenway Park. (Boston Globe)

Methuen made a temporary ban on recreational marijuana establishments permanent. (Eagle-Tribune)

Ipswich Fire Chief Gregory Gagnon threatened to shoot his wife if she didn’t leave their house, but later he told her she could return and use a spare bedroom. (Lowell Sun)

WASHINGTON/NATIONAL/INTERNATIONAL

International leaders are bracing for the unexpected when President Trump addresses the United Nations today with a speech drafted by his hard-line policy advisor Stephen Miller. (New York Times)

The conservative National Review says the incidences of police violence against blacks is a “false narrative” unchallenged by the media and distracts from more serious problems facing black Americans.

California is poised to become a sanctuary state. Will others follow? (Governing)

Joan Vennochi doesn’t think Sean Spicer’s appearance at the Emmys was funny, saying it put a “lighthearted spin” on the “mendacity” of the White House where he worked. (Boston Globe)

An American University history professor and a group of nine Massachusetts residents, one from each of the state’s congressional districts, urge the House to begin impeachment proceedings against Trump. (Boston Globe)

ELECTIONS

Mayor Marty Walsh holds a huge 31-point lead going into next Tuesday’s preliminary Boston election, according to an Emerson College poll, and would be an overwhelming favorite in a November match-up against City Councilor Tito Jackson, who seems likely to place second in the preliminary and advance to the final election. (Boston Herald)

Five of the eight candidates running for mayor in Lawrence, including incumbent Daniel Rivera, engaged in a debate that focused heavily on crime and drugs. (Eagle-Tribune)

Matthew Sisk, a Republican operative and former Department of Conservation and Recreation official who was forced to resign for abusing his position, has taken out papers to run for the Braintree Town Council. (Patriot Ledger)

The guy bouncing around Boston in a clown outfit campaigning for city council turns out to be local developer and political gadfly Kevin McCrea, who has legally changed his name to Pay Payaso, the Spanish word for clown. (Boston Herald)

BUSINESS/ECONOMY

Toys ‘R’ Us files for bankruptcy protection. (Reuters)

A Salem News editorial hails the housing boom on the North Shore, but acknowledges Salem Mayor Kim Driscoll is right in saying that it sometimes feels like a “congestion boom.”

An MIT-founded startup that targets firms facing complex technological issues plans to announce today that it has $200 million ready to invest in such enterprises. (Boston Globe)

EDUCATION

One of the nation’s largest student loan creditors was ordered to pay back millions of dollars and temporarily cease collection actions while independent auditors review the company’s 800,000 loans. (New York Times)

HEALTH/HEALTH CARE

A huge national conference on addiction treatment held last weekend on Cape Cod was cosponsored by a chain of treatment centers that was raided recently by federal authorities searching for evidence of fraud, money laundering, and illegal patient referral payments. (Boston Globe)

TRANSPORTATION

The MBTA and its machinists union, at odds over a proposal to privatize three bus maintenance garages, are back at the negotiating table and Brian Lang, a member of the Fiscal and Management Control Board, is trying to find common ground. (CommonWealth)

T notebook: New GM Luis Ramirez says most riders think MBTA doesn’t care about them. Plus, more on the T’s new fare collection system, a signals contract, and disparate treatment of minorities. (CommonWealth)

ENERGY/ENVIRONMENT

Hurricane Maria has quickly grown to a potentially catastrophic Category 5 storm and is bearing down on Caribbean islands that still haven’t recovered from Hurricane Irma. (New York Times)

A draft memo from Interior Secretary Ryan Zinke proposes opening up a marine monument 130 miles south of Cape Cod to commercial fishing. The area was declared a marine monument that restricted fishing by then-President Barack Obama in 2016 in a move that was decried by commercial fishermen but hailed by environmentalists. (GateHouse News Service)

A Falmouth community activist is trying get get selectmen to put an article in the Town Meeting warrant to peel back beach restrictions that would ban most types of ball playing and other games on town beaches. (Cape Cod Times)

CASINOS

MGM unveils plans for a $675 million gaming resort on the waterfront in Bridgeport, Connecticut, even though it doesn’t have legislative approval to proceed. MGM said the casino is designed to draw gamblers from the New York area south of Manhattan. (Hartford Courant) Springfield Mayor Domenic Sarno says he’s been assured by MGM officials that the company remains committed to his city and the new facility will not have any impact on the casino scheduled to open next year. (MassLive) In the current Summer issue, CommonWealth took a look at the growing casino war between Connecticut and Massachusetts, including MGM’s aggressive push to drive a stake in the ground in the Nutmeg State.

CRIMINAL JUSTICE/COURTS

A dental chain with offices in 11 states, including Massachusetts, has agreed to pay the federal government $1.4 million to resolve charges of fraudulent Medicare billing stemming from a complaint filed by the company’s Fall River office manager. (Herald News)

Conservative blogger Pamela Geller says she’s prepared to testify, if called, against a member of the trio who allegedly targeted her for beheading because she “organized a Prophet Muhammad cartoon contest.” (Boston Herald)

MEDIA

A group called Report for America is rolling out a program that is a lot like Americorps except for journalists. Charles Sennott, a former Boston Globe reporter, is helping to coordinate the effort to put 1,000 reporters in local newsrooms over the next five years. (Poynter)

SPORTS

West Bridgewater Middle-Senior High School freshman Colleen O’Toole became the first girl to ever play quarterback in a varsity football game in Massachusetts in a win over South Shore Vocational Technical High School. (The Enterprise)

PASSINGS

Former MIT president Paul Gray, credited with increasing racial diversity at the prestigious Cambridge university, has died at age 85. (Boston Globe)