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Baker’s reform proposals would make big change to MassHealth

Jule Pattison-Gordon | 7/13/2017, 6 a.m.

Late-in-the-game proposals from Charlie Baker’s administration attempted to rein in state budget costs by reducing MassHealth enrollment eligibility. In a June 20 letter to the legislature, whose budget was due about a week and a half later, the Baker administration outlined a package of proposed changes to the state’s health insurance system for low-income, disabled and elderly people. Health care advocates said they appreciated the tricky financial situation but noted that the moves have serious implications on people’s well-being and called for robust, public discussion.

“The governor seems committed to universal coverage and we’re pleased that he continues to do that but we think there’s a better way to do universal coverage than what he’s doing in this package,” Brian Rossman, research director for Health Care for All, told the Banner.

The package came in response to legislators’ request that the administration find ways to control current and future MassHealth spending. MassHealth represents about 40 percent of the state budget, with the vast majority of the cost increases due to enrollment growth, according to the state.

On Friday July 7, state lawmakers voted against the proposals reducing MassHealth eligibility for many families (as well as a proposal that would establish a new dental provider type), but supported a fee on employers to help pay for state health care costs. Some legislators said they rejected the proposals because they were not given sufficient time for evaluation or public debate. The budget now goes to Gov. Baker to sign or send back.

If the proposals had passed, about 140,000 low-income adults without disabilities would be transitioned off of MassHealth and onto commercial plans available through the state Health Connector. Non-disabled adults with access to employer-sponsored plans regarded as affordable would be unable to opt for MassHealth. These and other pieces of the policy proposals appeared to be part of a thrust to make employers — and not the state — pick up more responsibility for employee coverage. Other changes were intended to take advantage of federal subsidies.

In her June letter, Kristen Lepore, state secretary of administration and finance, strongly advised passing all the reforms together instead of picking and choosing, in order to achieve a balance budget and sustainable system. According to the state, the reforms generate fiscal year 2018 savings of about $114.6 million, with an additional $200 million gained in revenue, and about $88.3 million in savings in FY2019, when some of the provisions would go into effect. Several measures require legislative or federal approval.

After the legislature released its budget vote, a group of businesses including Massachusetts Taxpayers, the Massachusetts Business Roundtable, The Retailers Association of Massachusetts and others released a letter calling for the full package of proposals to be passed saying it was needed to redress underlying cost issues.

Eligibility rollback

Under now-rejected policies outlined by Lepore, non-disabled adult members of two-person households with incomes over 100 percent of the federal poverty level (incomes between $16,240 and $21,600, according to The Boston Globe) no longer would qualify for MassHealth. This pool includes about 140,000 people, of which an estimated 100,000 are parents. They would have to use ConnectorCare commercial plans, with higher costs and less expansive coverage, advocates say.