Baker taking wait-and-see approach to ACA changes

Gov. Charlie Baker on Wednesday said he doesn't want to speculate about what national Republicans have planned for the future the Affordable Care Act, but vowed to ensure that Massachusetts residents have access to health care. [Video: Antonio Caban/SHNS]
Gov. Charlie Baker on Wednesday said he doesn't want to speculate about what national Republicans have planned for the future the Affordable Care Act, but vowed to ensure that Massachusetts residents have access to health care. [Video: Antonio Caban/SHNS]

STATE HOUSE, BOSTON, JAN. 4, 2017…..As some in Washington D.C. prepare plans to disassemble the Affordable Care Act others in Massachusetts are girding for a battle to ensure Bay State residents will have the same access to health coverage and care.

President-elect Donald Trump ran with the promise of repealing the ACA quickly and with Republicans in control of both branches of Congress, Trump appears to have a path to make good on that pledge in his first two years.

Though talk of repealing and replacing the ACA has consumed Washington and state capitols, very little is known about exactly how Trump and Congress will dismantle the federal health insurance law or whether his administration would propose or support a replacement.

While President Barack Obama met with the Democrats who stand between the Republican-controlled Congress and full repeal of the ACA, Vice President-elect Mike Pence on Wednesday met in Washington with Congressional Republicans to reaffirm that dismantling the ACA will be Trump’s “first order of business.”

“The American people have spoken,” Pence said, according to CBS News. “They want to see us repeal and replace Obamacare.”

But in Massachusetts, the state whose 2006 health care access expansion law became a model for the federal ACA and where roughly 96 percent of residents have health insurance, the prospect of dramatic changes to the federal law has not been met with great enthusiasm.

Gov. Charlie Baker, a former health care executive, said Wednesday that he senses “a pretty deep commitment” on Beacon Hill to maintaining Massachusetts’ standing as a leader in health care coverage “no matter what happens at the federal level.”

“I think as most people know, Massachusetts had virtually universal coverage in place before the federal health care law passed. We currently secured a five-year waiver from the Obama administration to build on the success that we’ve had here in Massachusetts,” the governor told reporters. “I’m not going to speculate on what the terms or conditions or the nature of whatever it is might happen in Washington will look like, but we’ll obviously work to make sure that the people of Massachusetts continue to have access to a system that virtually covers everybody.”

The Massachusetts Coalition for Coverage and Care, a group of health care and human service providers, launched this week to educate policymakers on the effects a repeal of the ACA would have on Massachusetts, echoed Baker’s commitment to ensuring that federal actions do not disrupt health coverage for Massachusetts residents. But unlike Baker, the coalition took a more dire view of an ACA-less future.

“There seems to be a belief among some that no matter how Congress and the president-elect act with regard to the ACA, Massachusetts will be protected because we passed state health reform (Chapter 58) in 2006,” said Audrey Shelto, president of the Blue Cross Blue Shield of Massachusetts Foundation and a coalition member. “In fact, there is a tremendous amount at risk here if the ACA is repealed, including the loss of coverage for hundreds of thousands of residents as well as millions of dollars in federal funding. All of our gains are jeopardized under such a scenario.”

The coalition includes Health Care for All, the Massachusetts Association of Health Plans, the Massachusetts Health and Hospital Association, the Massachusetts Medical Society, Partners Health Care, Boston Children’s Hospital, the Associated Industries of Massachusetts, 1199SEIU and others.

Asked whether he supports what Congressional Republicans have suggested they will do with the ACA, Baker did not answer directly.

“It depends a lot on the details and I’m not going to speak to that until we see them,” he said. “Some of them have talked about giving states more latitude to do what they think makes the most sense for their states. That’s something that any governor and any Legislature would probably be in favor of.”

As a candidate for governor in 2014, Baker focused steady criticism on the state’s implementation of the federal ACA and repeatedly said Massachusetts should push for a full waiver from the ACA, noting success under the state’s 2006 health care access law.

Candidate Baker credited the trend toward consolidation and mergers in the health care marketplace to enormous regulatory changes imposed on the industry by the ACA, and warned that Massachusetts doctors and hospitals would be hit harder than their counterparts in most states by cuts to Medicare to pay for the law.

Copyright 2017 State House News Service

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