January 15, 2017

On Beacon Hill: Obamacare, the Trump effect and a budget boondoggle

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Antonio Caban / State House News Service

Gov. Charlie Baker

Recap and analysis of the week in state, and federal, government
from State House News Service

In five days, Donald Trump will become president of the United States of America.

In 10 days, Massachusetts Gov. Charlie Baker will file a budget proposal, his third, for fiscal 2018.

And in 298 days, voters in the city of Boston will choose a mayor for the next four years.

Because of the uncertainty, to various degrees, surrounding each of those moments, the early days of January have become an exercise in preparation and positioning, none more prominent nor sprinkled with question marks than what happens after Trump takes the oath of office.

From secret dossiers on Russian interference and collusion to Cabinet nominees contradicting policy statements made by the president-elect as confirmation hearings got underway, the Trump effect could not be ignored last week by even the most parochial of politicos who come to work each day on Beacon Hill.

Even Baker, who has tried at every turn to resist getting drawn into the Trump orbit, could not avoid putting his thumb on the scale of the healthcare debate that heated up in the Republican-controlled Congress to a scorching degree last week.

Wikimedia Commons / Gage Skidmore

Donald Trump

Trump has called the Affordable Care Act (ACA) a failed “disaster,” and House Speaker Paul Ryan described Obamacare repeal as a “rescue mission,” but Baker, in a detailed and lengthy response to questions from Congress, defended key aspects of the ACA — such as protections for patients with pre-existing conditions against denial of coverage — and offered a laundry list of tweaks that would give states more flexibility to customize healthcare systems without jeopardizing access.

Among Baker’s chief ACA concerns is how its expansion of government-funded health insurance has produced a surge in MassHealth enrollment in Massachusetts, putting unsustainable financial pressures on the state budget.

MassHealth enrollment is already forcing the administration to solve $600 million in increased costs next year (see story below). What happens in Congress could further impact state finances as the budgeting process for fiscal 2018 gets underway.

— Matt Murphy

OFF THE TOP

  • BUDGET BASELINE: Administration and Finance Secretary Kristen Lepore, and House and Senate Ways and Means chairpersons Rep. Brian Dempsey, D-Haverhill, and Sen. Karen Spilka, D-Ashland, agreed to an estimate for fiscal 2018 that will assume $27 billion in taxes are available to help finance what will likely be the state’s first $40 billion budget. The revenue estimate assumes 3.9 percent growth in tax revenues when growth through the first six months of the current fiscal year has topped out at 2.3 percent. So despite the administration and legislative leaders using words “conservative,” “cautious” and “modest” to describe the forecast, it once again runs the danger of being anything but that.

ALSO ON THE AGENDA

  • Neal spars with Ryan over Obamacare repeal
  • A ‘positive’ outlook on statewide property values
  • The next steps for online gaming
  • MassHealth surge strains state budget
  • Loans forgiven for students of fraudulent training school

THE BIG DEAL

Neal holds Ryan’s feet to fire in debate over Obamacare repeal, potential solutions


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