With the
Massachusetts House’s budget proposal for FY18 expected to be
filed the week of April 10, MHA has been on Beacon Hill advocating for a
number of priorities on behalf of the hospital
community.
After Governor Charlie Baker filed his budget proposal in
January, MHA weighed in with a pointed letter highlighting strong
opposition to the governor’s plans to impose direct government
regulation of provider payments in the commercial insurance market,
including growth caps on commercial payments to providers, limitations
on contracts covering Group Insurance Commission members, and a
directive to eliminate facility fees.
In a letter to House Ways & Means Chairman
Brian Dempsey (D-Haverhill) this month, MHA reiterated its opposition to
those proposals but focused its attention on other budget priorities
related to the Health Safety Net (HSN) and MassHealth
program. MHA advocated for strengthening the financing of the
Health Safety Net, including the restoration of $30 million in state
funding for the program. Despite a statutory directive requiring the
state to invest $30 million in the HSN, the governor’s proposal
did not include any state funding. The safety net has been in
a constant state of shortfall for many years, including FY2016 which
ended with a $109 million shortfall. Hospitals alone bear the burden of
all shortfalls, in addition to the assessment they pay to fund the
program.
MHA
also urged for the legislature to restore enhanced Medicaid payments to
Disproportionate Share Hospitals (DSH) in recognition of the large
numbers of low-income patients cared for by these facilities. Although
such payments were included in the FY2017 budget, hospitals learned
shortly after its passage that MassHealth would be eliminating the
FY2017 DSH supplemental payments through changes in payment
methodology.
Another priority MHA cited is to ensure post-acute
hospitals receive additional Medicaid funding now that they will be
paying a new annual assessment under the governor’s
budget.
Recognizing the great uncertainty that remains about the
future of federal Affordable Care Act funding in light of the sustained
efforts to repeal key provisions of the law, and stressing the
continuing pressure on Massachusetts given inadequate MassHealth payment
levels, MHA’s letter to Dempsey noted, “The continuous path
of cutting provider reimbursement to cover the costs of expanding
MassHealth enrollment is not a viable long-term path and is weakening
providers while endangering access to needed services. We hope that we
can work together to secure a solid foundation for existing program
funding and operational processes so that any payment and delivery
reforms will be successful for patients, healthcare providers, and the
commonwealth.”