House Advances Shared Responsibility

The House today approved a supplemental budget bill (H. 5022, House press release/summary) that includes a modified version of Governor Patrick’s shared responsibility funding proposal to meet the MassHealth and Commonwealth Care shortfall for this year. The House decisively rejected two amendments to strike the assessment provisions in the bill.

Speaker DiMasi’s statement put the bill in perspective: “Our successes in health care reform have been unprecedented and we must do everything we can to guarantee we succeed on our commitment to insure virtually every man, woman and child in the Commonwealth. These modest changes, at a time when we are addressing head‐on rising trends in health care costs, strike the right balance between asking everyone involved to do more without over‐burdening any one group.”

The Senate is expected to take up the bill on Wednesday.

The health reform revenue provisions are similar to the Governor’s proposal, with two main exceptions. First, the House bill does not include the provision reducing teaching hospital adjustments in payments from the Health Safety Net (HSN). As a result, teaching hospitals would not see a $16 million cut in HSN payments.

Second, the bill excludes a provision setting an enforceable revenue target of $38 million for the employer Fair Share Assessment. Under the Governor’s bill, the $295 per worker annual Fair Share Assessment amount would be increased or decreased so that revenue hit the $38 million target. This would represent an approximate $33 million increase from this year’s projected revenues. Removing that section from the Governor’s bill preserves the $295 Fair Share Assessment cap, a key goal of the business community.

Business groups were still concerned, since the administration still has the authority to change the test of “fair and reasonable” that triggers a fair share assessment. This regulatory authority was never a part of the legislation, and remains as before an administrative revenue option. The administration is considering changing the “or” to “and” in the current requirement of either covering 25% of one’s employees or a third of the premium. Chair Walrath reiterated to WBUR that this proposal would still be far weaker than what the legislature had in mind when health reform was passed.

During the House debate, Republicans filed amendments to strike the assessment sections. The amendments were soundly defeated, mostly along party lines, with just a few Democrats crossing over to vote with the Republicans. An amendment to strike the quarterly Fair Share assessment payments was defeated 23-127, and an amendment to strike the insurer, hospital and Medical Security Trust transfer was defeated 24-129. Health Care Finance chair Patricia Walrath spoke knowledgably in opposition to both amendments.

We’re pleased that the House approved a responsible, measured approach to closing a funding gap. Without sufficient funds, health reform would begin to unravel as program enrollments are restricted, requiring waivers of the individual mandate, and increased HSN costs. We urge the Senate to follow the House lead and approve similar provisions in its version of the bill.

ALSO: Two other key bills were approved today, each advancing equality in its own way. The mental health parity bill will allow those suffering from a number of serious mental health conditions to receive treatment equivalent to those with physical illness. The MassHealth equality bill will allow same-sex married couples to be treated as all other married couples when applying for and receiving MassHealth benefits. Both bills advance justice, and we urge the Governor to sign both.

With two days left in the formal session, we’re anxious for the substantial agenda still on the legislative plate. Finishing the supplemental budget, the big cost and quality bill (drug industry lobbyists were out in force in the State House today), the children’s mental health bill, and the omnibus oral health bill are all still pending (details here). Both branches were in late tonight, and it should be long days and late nights until the midnight Thursday deadline.
Brian Rosman

About HCFA

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1 Response to House Advances Shared Responsibility

  1. ? says:

    Insure virtually? Is Sal cognoscent?

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