In a letter to U.S. House Majority Leader Kevin McCarthy (R-Calif.), Massachusetts Governor Charlie Baker wrote that while a bill the size of the ACA may contain flaws, the health reform legislation has been beneficial to the state and efforts to repeal and replace it must follow “a measured and objective analysis” and provide ample time for transition.
Referencing the enrollment website that plagued the roll-out of the ACA in Massachusetts, Baker wrote, “Although the state’s initial implementation of the Affordable Care Act was deeply flawed, today more than 220,000 individuals have healthcare coverage through our state exchange, 180,000 low to modest income residents receive federal and state subsidies, and an additional 300,000 adults are enrolled in Medicaid as a result of the expansion allowed through the Affordable Care Act.”
The governor also stressed the “economic engine” aspect of Massachusetts healthcare, noting that the sector contributed $19.77 billion to the state’s economy, “outpacing any other industry.” Also 10% of the state’s entire workforce is employed in healthcare related fields, Baker wrote.
The governor wrote that complying with the ACA mandates, which superseded the original Massachusetts reform law, has resulted in people shifting out of employer-sponsored coverage into public coverage. He says this shift has disrupted the commonwealth’s “coverage landscape and contributed to challenges in the growth of the Medicaid program.” But he also noted the ACA’s benefits, including a ban on pre-existing condition exclusions, elimination of annual or lifetime limits and gender inequities, and authorization of important demonstration projects such as the one Massachusetts has undertaken for residents dually eligible for both Medicaid and Medicare.
Baker cautioned Congress to act carefully when addressing the ACA, noting that Medicaid is “a shared federal/state partnership.”
“Proposals that suggest states may be provided with more flexibility and control must not result in substantial and destabilizing cost shift to states,” he wrote. Baker urged “ample time for transitioning into new healthcare coverage and/or delivery models to ensure operational readiness.”