Massachusetts policymakers are currently engaged in a robust debate over several proposals aimed at lowering health care costs in the Commonwealth. The House of Representatives rejected a set of MassHealth reforms that the Baker Administration submitted to the legislature along with an employer assessment as part of a package aimed at lowering costs in the state’s Medicaid program. The Baker Administration also submitted an amendment to the state’s federal Medicaid waiver seeking approval from the Trump Administration for a set of MassHealth reforms. At the same time, Governor Charlie Baker filed separate legislation increasing the minimum premium differential for tiered networks, expanding the scope of practice for certain providers, and requiring payers to submit to the Center for Health Information and Analysis (CHIA) information on payment rates to specific providers. Debate also continued on pharmaceutical drug pricing, with the Baker Administration including pharmacy benefit reforms as part of the MassHealth waiver and the Health Care Financing Committee holding a hearing on July 11 on the multiple bills that have been introduced this session.

Legislature Rejects Governor’s Proposed MassHealth Reforms -

On July 26, the House rejected the MassHealth reforms the Baker Administration had added into the FY2018 budget through an amendment. The House turned down the reforms on a vote of 116-41, with seven Democrats joining all but one Republican in supporting Governor Baker’s amendment one day after the Joint Committees on Health Care Financing and Ways and Means held a hearing on the proposals. These reforms included shifting 140,000 non-disabled adults with incomes above the federal poverty line from MassHealth to subsidized private insurance through the Connector, shifting 230,000 MassHealth members from standard MassHealth coverage into CarePlus, and disallowing MassHealth coverage for non-disabled adults who have access to employer health insurance.