MA Health Reform Update — The Squeeze Play

Two noteworthy events this week — one on camera and one off (well, sort of).

On Tuesday, Sen. Kennedy and Gov. Romney met in DC with Mike Leavitt, US Secretary of Health & Human Services about the fate of Massachusetts’ Medicaid waiver — worth about $770 million to the Commonwealth. Critical issues — such as the status of Boston Medical Center as a public entity — were discussed and unresolved. Left is a picture from the meeting — with Sen. Kennedy, Sect. Leavitt, and Gov. Romney. In the very back is Dennis Smith who runs Medicaid for the federal Centers for Medicare and Medicaid Services, and who is in charge of the waiver negotiations.

Sometime this week, Smith sent an undated letter to Tim Murphy outlining their expectations that “beginning on July 1, 2006, the Commonwealth must find an alternative financing arrangement … to provide health care services to uninsured individuals …” You can read the full letter on HCFA’s site by clicking here.

What the heck does all of this mean? Briefly, the Romney Administration sold the Bush Administration on their health reform plan, and now is using the potential loss of federal dollars to pressure the Legislature to approve their proposal. The Smith letter was more than likely solicited by the Romney Administration. We are seeing in states across the nation — most recently Vermont — the Bush Administration colluding with Republican governors to compel recalcitrant state legislatures to remodel their Medicaid programs to set limits on available federal dollars. In Massachusetts, the process is being used to promote the Romney plan for limited benefit insurance plans.

On Thursday, Gov. Romney testified for about an hour before the Legislature’s Joint Committee on Health Care Financing and Joint Committee on Financial Services. The topic was his health reform legislation filed last July. Click here for a news account. The centerpiece of the plan involves private insurers offering low cost insurance plans with a target premium of $200 per month for a single person in his or her 20s (higher for older adults and families). Lower income folks would get subsidies to support their premiums. I presented written and oral testimony. Click here to read it.

Key point — after 10 months of bragging across the nation about his health reform plan, to date not one insurer has come forward with a plan they are willing to offer at the target price. If there are no private plans, there is no Romney plan. Yet this is what the feds are trying to compel the state to adopt.

Stay tuned…

About HCFA

The Ultimate Massachusetts Health Care Insider Information
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