$40.5 billion Massachusetts health care budget filed

BOSTON (STATE HOUSE) – Lawmakers will need to study the health care market reforms proposed in Gov. Charlie Baker’s fiscal 2018 budget as they decide how to respond, the most recent House chairman of the Health Care Financing Committee said Thursday.

The $40.5 billion budget, filed on Wednesday, takes a series of steps aimed at controlling spending growth in MassHealth, the state Medicaid program that now accounts for nearly 40 percent of state spending and insures nearly 2 million people.

Baker’s plan includes an assessment on certain employers without at least 80 percent of their workers covered by employer-sponsored health care, rate growth caps for certain care providers, a five-year moratorium on new coverage mandates, and additional consumer transparency efforts to help patients understand the cost of care.

“Looking at that budget, they made that a health care budget,” Rep. Jeffrey Sanchez said Thursday during a policy forum held by the American Cancer Society Cancer Action Network at the University of Massachusetts Club.

Sanchez, who co-chaired the Health Care Financing Committee during the 2015-2016 session, also released a statement Tuesday night saying the slate of health care changes Baker laid out “appears to be a reform plan that relies primarily on moving spending away from the state and back to employers.”

“Touching on affordability and sustainability, it requires further analysis to better understand the impact on families and residents of the Commonwealth,” he said.

Sanchez and Sen. James Welch chair a commission of state officials and health care industry representatives studying variations in the prices charged by different providers for similar services. The panel has a March deadline to recommend strategies for addressing unwarranted variations. It’s a topic that lawmakers have wrestled with for years, hesitating to intervene in a largely deregulated market.

Sanchez said Baker’s budget “put some fire behind” the commission and lawmakers in general as they grapple with rising health care costs and seek ways to keep medical spending growth in check. He said deciding what approach to take is made more challenging by uncertainty around the federal Affordable Care Act, which President Donald Trump has pledged to repeal.

“That’s where the question lies. Do we do that, and then all of a sudden Trump pops up with something else and then we start off at the starting gate again,” the Jamaica Plain Democrat said. He later added, “With the budget having all of these ideas, the question is, do we do all of this now, or how do we do this?”

The House and the Senate will propose their own budgets, which can include, alter or leave out the policy recommendations made by Baker. The House budget will come next, with the Senate putting forth its proposal last and a conference committee then reconciling the differences.

Senate Ways and Means Chair Karen Spilka said that by the time the Senate crafts its budget, more information may be available on what policies Trump and the Republican-controlled Congress plan to offer in place of the Affordable Care Act.

She said lawmakers and other officials “may need to respond quickly” to a potential loss of federal funds in order to make sure the state can provide the same level of services.

“We are looking already at what can we do to minimize disruption on a state level,” said Spilka, an Ashland Democrat, at the American Cancer Society event. “Without knowing what any specifics are, it’s kind of hard.”

The Affordable Care Act delivered significant funds to Massachusetts and expanded eligibility for MassHealth. But for several years before the ACA was adopted in 2010, Massachusetts operated under its own expanded health care access law which was signed in 2006 by Gov. Mitt Romney.

Copyright 2016 State House News Service