Ever since Governor Charlie Baker released his administration’s FY19 state budget proposal, MHA and the hospital community have been digging into it to assess the document’s potential effect on the many provisions relating to healthcare and patient access. Last week, MHA weighed in with the House Ways & Means Committee as it prepares to take the next step in the state’s budget process.
A major component of the governor’s proposal is to permit non-disabled adults with incomes above 100% of the federal poverty level (FPL) to be only eligible for subsidized insurance in the Connector exchange rather than through MassHealth. This proposal was submitted to the legislature last summer for its consideration and EOHHS is also seeking federal approval through a recently filed MassHealth waiver amendment. The FY2019 budget assumes this change will yield $60 million in net state savings given the effective date of January 1, 2019.
The eligibility change would not apply to disabled adults, pregnant women, and individuals with HIV or breast and cervical cancer. Veterans with access to veterans’ healthcare benefits that make them ineligible for tax credits in the Connector would also be unaffected. In addition to state law changes, this proposal requires approval from the Centers for Medicare and Medicaid Services (CMS). This provision was included in a waiver amendment submitted to CMS last September.
In its letter, MHA notes that it shares Governor Baker’s perspective that the state is at a point in time when changes are needed to make the MassHealth program sustainable. MHA supports the directional changes the governor proposes in conjunction with steps to ensure appropriate affordability standards and guard against any loss of coverage.
MHA’s letter also reminded legislators of the daunting costs posed by the pending statewide ballot question that would mandate nurse staffing ratios. Among the proposal’s many shortcomings is its cost; conservatives analysis shows the measure would cost well over $800 million per year without offering any benefit to patient care. The cost would have to be borne by patients and families that already are struggling to pay for healthcare, as well as by business, labor, and state government.
Other key hospital key community priorities for FY19 focus on the health safety net, funding for disproportionate share hospitals and needed investments in behavioral health services.
It is anticipated that the House Ways & Means Committee will release its proposal on or around April 11.