Editorial: Baker Shows Way on Health Reform

By Herald Staff

The Baker administration has thrown the Legislature — and the taxpayers — a lifeline when it comes to dealing with rising Medicaid costs — which account for nearly 40 percent of the state budget. Lawmakers should grab it.

To do so — especially with the uncertainty in Washington, D.C., on health care these days — the administration has gone to the Way-Back Machine, returning to the concepts and efficiencies the state was able to implement under Romneycare back in 2006. Yes, before Obama- care chewed up a perfectly good system that had managed to insure 97.8 percent of the state’s population.

So now Gov. Charlie Baker, who knows a little something about the business of health insurance himself, is proposing a way out of a more than $300 million budget hole created by mounting costs of the $16.6 billion MassHealth program.

Under the plan outlined yesterday, businesses would have to come up with about $200 million a year for the next two years (the fee would sunset in 2019). Part of that (about $75 million) would come from an increase in the Employer Medical Assistance Contribution from the current maximum of $51 per employee to $77 per employee. The rest would come from an assessment on companies with more than six employees capped at $750 for each non-disabled employee who chooses to enroll in MassHealth instead of an employer-sponsored health insurance plan.

When even the head of Partners Health Care concedes that some of his employees are on MassHealth, well, that’s a problem. And maybe that genie can’t be put back in the bottle, but business can be part of the solution.

As a sweetener for business, the Baker administration plan proposes to slow the rate of increase in unemployment insurance costs, thus saving businesses $334 million over two years.

Which explains why major business groups — the Mass High Tech Council, the Retailers Association of Massachusetts, and the Massachusetts Taxpayers Foundation — along with Fallon Health and Boston Medical Center have already signed on in support.

For its part, the Legislature would also have to commit to a five-year moratorium on new insurance mandates. No more micro-managing of health care coverage from the halls of the State House.

Making the numbers work is also predicated on some cooperation from the feds, including federal permission to prevent non-disabled workers with access to employer-sponsored coverage from enrolling in MassHealth, creating limited networks through accountable care organizations and limiting MassHealth pharmacy benefits and networks.

Many lawmakers have acknowledged that they were hoping the governor would come up with a comprehensive plan that could become part of the budget before the fiscal year ends June 30. This is as good as it can get.

But it is a package of reforms; it cannot be nickled and dimed to death. Lawmakers should recognize that it is far more than the sum of its parts, and take due note of its support among those who will be paying the bills.