Last week Governor Baker signed a $39.4 billion state budget, vetoing about $222 million in MassHealth line while sending back to the legislature proposed healthcare amendments to the budget that Baker wants action on within 60 days.
Legislative leaders said they’d give attention to the governor’s proposals to increase the per-employee health insurance assessment employers would have to pay, as well as to reforms of the MassHealth program. But the legislature made no promises about passing the governor’s plan. The governor initially had recommended his package of employer assessment and MassHealth reforms in June.
In that June package, Governor Baker sought an increase to the per-employee Employer Medical Assistance Contribution (EMAC) for all employers with six or more workers; employers whose workers receive coverage through MassHealth and subsidized insurance in the Health Connector exchange – even if their employer offers insurance – would pay a supplemental assessment. The legislature included this provision in its final budget, but did not couple it with the MassHealth reforms sought by the governor.
In returning the provision to the legislature, Baker wrote, “These [employer-assessment] sections …must not be considered in isolation of other measures needed to manage spending in the MassHealth program. Absent other reforms, this proposal imposes an unfair burden on Massachusetts’ employers without making the structural reforms essential to MassHealth’s long-term sustainability.”
Those proposed MassHealth changes include:
• Moving 140,000 non-disabled adults with incomes above 100% of the federal poverty level from MassHealth to subsidized insurance through the Health Connector exchange. (Pregnant women, those with HIV-AIDS, and those with breast or cervical cancer would be excluded from this MassHealth-to-Connector switch.)
• Disallowing MassHealth coverage for non-disabled adults who have access to employer health insurance.
On Thursday, the Executive Office of Health and Human Services (EOHHS) proposed an amendment to the state’s Medicaid waiver that including the aforementioned reforms and others, including changes to covered benefits for certain MassHealth enrollees, the MassHealth premium assistance program, and pharmacy formularies. EOHHS is seeking comments by August 21.
The administration says such moves will “better align the MassHealth program with commercial insurance products and coverage,” but patient advocates say the moves will result in higher out-of-pocket costs for poor people and ultimately result in higher uninsurance levels in the state. The governor said if the legislature does not act within his 60-day deadline then he’ll be forced to make further budget cuts to cover what he called the “foregone revenues and savings associated” with his proposals.