Recap and analysis of the week in state, and federal, government
from State House News Service
As Congress convulsed over a decision to repeal and replace Obamacare, Gov. Charlie Baker took baby steps toward a declarative “no” on the GOP health bill while he tested his own deal-making skills back in Boston.
The healthcare showdown in Washington took a circuitous path to the dramatic moment Friday afternoon when House Speaker Paul Ryan, after seven years of his party promising to repeal the Affordable Care Act, pulled the replacement bill from the floor.
The American Health Care Act, as it was called, crumbled under the weight of unanimous Democratic opposition and conflicting Republican ideologies, and Gov. Baker, it would seem, was able to breathe a sigh of relief.
Earlier in the week, Baker wrote to the state’s all-Democratic Congressional delegation warning that the AHCA could siphon up to $2 billion in federal funding for Medicaid from Massachusetts and threaten the state’s “continued commitment” to universal health coverage.
Baker ended by saying simply that he hoped his analysis would prove “useful” in the debate.
And when the Telegram & Gazette editorial board tried to pin him down Thursday, Baker said he doesn’t like when others tell him how to do his job, and wouldn’t presume to tell members of Congress how to do theirs.
Something (or maybe nothing) changed between that late afternoon meeting and 10 p.m., when Baker pulled out his phone to tell his Twitter followers that the AHCA “should not pass” in its current form.
He got his wish Friday, when Ryan conceded that Obamacare would be the law of the land for the “foreseeable future.”
With or without the AHCA, the governor and legislative Democrats are probably going to have to come to some type of agreement on how to address surging MassHealth costs. Enrollment growth in the state Medicaid program threatens to box out other priorities in coming budgets, but building a consensus around who should help pay for that health coverage, and how, has been difficult.
Baker initially put forward a plan to penalize employers that didn’t cover a substantial number of their workers $2,000 per full-time employee to offset the cost to the state of providing that coverage through MassHealth.
Balking business leaders, however, have put that proposal in serious jeopardy, and the administration has been working behind the scenes with business groups on an alternative strategy that would abandon the idea of penalizing employers for not covering their workers.
Business would still pay under the alternative plan being developed, but not the full $300 million Baker had been counting on to balance his budget plan. The pain would also be spread across a broader swath of the employer community with an increase in what is known as the Employer Medical Assistance Contribution, which is used on healthcare for low-income and uninsured residents.
Whether this concept will fare any better than the employer assessment is still an open question. While small business groups called it “preferable” to Baker’s pending budget proposal, Greater Boston Chamber of Commerce President James Rooney said it was still built on the “flawed” premise that employers should be the ones riding to the rescue.
“Penalizing employers who provide their employees with good-quality health care benefits should not be part of the solution,” Rooney said.
— Matt Murphy
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