A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

HCFA Opposes MassHealth Cuts in Governor's Proposed FY 2017 Budget

HCFA Opposes MassHealth Cuts in Governor's Proposed FY 2017 Budget

January 29, 2016

Baker admin files FY 2017 budget

On Wednesday, Governor Baker released his proposed state budget for fiscal year 2017, which begins on July 1, 2016. While the budget provides for an approximate 5% growth rate for MassHealth spending, administration officials had projected that total MassHealth expenditures would rise around 8% next year, due to increases in the caseload and medical inflation. As a result, the budget calls for spending cuts in a number of areas, and freezes in many reimbursement rates.

The cuts were covered in an article by the Springfield Republican State House reporter Shira Schoenberg: Gov. Charlie Baker's budget finds ways to trim MassHealth spending:

Some advocates worry that proposed changes could limit access to some benefits.

One change is MassHealth is moving more people away from fee-for-service plans toward managed care organizations, where a provider group is paid one fee to coordinate all of a patient's health care. The state will eliminate some benefits from fee-for-service plans and keep those benefits in managed care plans, as an incentive to switch. These benefits include physical, occupational and speech therapy, chiropractic benefits and vision. ...

But the health care advocacy group Health Care for All opposes the changes. Restricting benefits in fee-for-service plans "unnecessarily restricts member choice and may impose barriers to accessing certain benefits and providers," said Health Care for All Executive Director Amy Whitcomb Slemmer. Locking members into one plan for a year, she said, "can have a negative impact on access to care and reduce flexibility to find a network that meets the members' individual needs."

In another area, the state has a Health Safety Net plan that reimburses hospitals and community health center for caring for uninsured or underinsured residents – generally, people who do not qualify for other plans, such as illegal immigrants and people waiting for employer-sponsored care. The state wants to lower eligibility from individuals earning four times the federal poverty level ($47,000 for an individual) to three times the poverty level ($35,400), according to Health Care for All.

"It will get a very fair look, because I think our goals are the same." - Sen. Jim Welch

"This would hurt their ability to get the health care they need and stay healthy," said Health Care for All research director Brian Rosman.

Health Care For All's Executive Director, Amy Whitcomb Slemmer, issued the following statement in response to the Governor's proposed budget:

"Health Care For All appreciates Governor Baker's budget proposal that preserves and invests in many critical health-related programs.

"We especially applaud the decision to maintain dental benefits for adults in MassHealth. Having access to good oral health care is critical for vulnerable populations in order to prevent health complications.
 
"We are also pleased that the Governor proposes to keep MassHealth payment rates steady, and even increase some rates for behavioral health and substance abuse services under the MassHealth program. We know that paying fair rates to providers will encourage more to accept MassHealth coverage, increasing access to needed care for patients seeking diagnosis and treatment.
 
"However, we strongly disagree with the proposal to lock MassHealth members into a specific managed care plan for 12 months. This can have a negative impact on access to care and reduce flexibility to find the network that meets the members' individual needs.
 
"We oppose his proposal to restrict benefits for some in MassHealth in order to push members into managed care plans. This unnecessarily restricts member choice and may impose barriers to accessing certain benefits and providers.
 
"We are also deeply concerned about proposed cuts in eligibility for the Health Safety Net program. This increases the risk of medical debt for low- and moderate-income residents who are uninsured or underinsured.
 
"We are encouraged by the Governor's focus on solutions to family homelessness and support his call to raise the Earned Income Tax Credit (EITC) to 50%. This credit provides a valuable increase in a family's income that has been shown to have multiple beneficial impacts, particularly for children. Research has shown that the EITC can be linked to improved child health, better academic performance, and higher income levels as adults.
 
"We look forward to working with the Baker Administration and the legislature to advance policies and regulations that aim at improving health care access and health outcomes for all Massachusetts residents."
The budget next will be considered by the House Ways and Means Committee, and then the full House, followed by the Senate,with their action expected in the spring and early summer.