Baker not leaping into fever-pitch health care bill debate

The bill presents significant policy and political concerns for the governor

BOSTON (STATE HOUSE NEWS SERVICE) – Republican Gov. Charlie Baker declined Thursday to weigh in on what he’d like to see happen with monumental health care legislation that could surface for a vote in the U.S. House on Friday, depending on the outcome of overnight vote wrangling by GOP leaders in Washington.

Asked by Worcester Telegram & Gazette editorial board members about the American Health Care Act and what he might do differently if he were involved in crafting it, Baker said, “I don’t really like it when people who don’t have my job try to tell me how to do it. So I’m unlikely to try to tell them how to do theirs.”

The bill presents significant policy and political concerns for the governor, who this year is pressing for rate caps and new assessments on employers to address rising health care costs and soaring MassHealth enrollment that has occurred since eligibility expansions were approved under Obamacare.

Policies in the GOP bill could knock people off health insurance, according to the Congressional Budget Office, and drain major revenue sources from state budgets, including the one Baker is managing. But Republicans from outside Massachusetts have supported Baker politically and the GOP governor appears reluctant to express opposition to a bill drafted by party leaders and aimed in part on creating savings for American consumers.

Members of the state’s all-Democrat Congressional delegation have been railing against the bill in recent days, urging Congress to reject it and asserting it will leave millions of people uninsured and decimate state budgets by removing Medicaid funding supports.

Without taking a position on the bill, Baker this week released a letter he wrote to members of the Massachusetts Congressional delegation in which he estimated the American Health Care Act sponsored by leaders of his Republican party in Washington would result in $1 billion less in federal revenue for Massachusetts in 2020, $1.3 billion less in 2021 and $1.5 billion in 2022, “with likely a greater annual impact in the years that follow.”

“Overall, our analysis indicates that the AHCA would increasingly strain the fiscal resources necessary to support the Commonwealth’s continued commitment to universal health care coverage. I hope this information is helpful to you as Congress takes up the American Health Care Act,” Baker wrote.

In January, well before the GOP bill was unveiled, Baker wrote a letter to U.S. House Majority Leader Kevin McCarthy outlining his thoughts for how to “improve upon the goals” of the Affordable Care Act (ACA), which is being targeted by Congressional Republicans, and cautioning against shifting costs to the states and eroding coverage gains.

The governor in his letter said giving states more flexibility to tailor health care systems to the needs of residents would be beneficial, but called the expansion of health coverage under the ACA and its patient protections – a ban on insurance denials for pre-existing conditions, the elimination of annual and lifetime limits, and the promotion of gender equity – “important provisions” of the law.

“I continue to believe the best approach for us to take on this is to continue to say what we believe would be the reforms that would be helpful in Massachusetts and the things that we think would be problematic,” Baker told the Telegram & Gazette during a meeting broadcast Thursday afternoon on Facebook Live. Seated with Lt. Gov. Karyn Polito, Baker said, “We’ve both been around this game enought to know that we’re in the first inning of a game that’s going to have all kinds of twists and turns along the way.”

A floor vote in the U.S. House was planned for Thursday, but postponed until Friday as Republicans tried to cobble together more support for their bill.

“I do think the fact that they put the vote off today implies that a lot of people are being heard,” Baker said.

While his party leaders hold control of Congress and the White House, Baker said he’s been communicating largely with Massachusetts members of Congress during the health care bill talks and with other governors, including governors from states with Republican members of Congress.

“I fully expect that the debate in the House will be contentious and difficult,” Baker said.

Baker on Friday plans to join Sen. Elizabeth Warren, Congressman Joseph Kennedy, state Sen. Michael Rodrigues, state Rep. Carole Fiola and Fall River Mayor Jasiel Correia for a 2:30 p.m. event to mark the grand opening of the Amazon Warehouse in Fall River.