Prescription for pain
Getting businesses to fork over more money to help pay for health insurance for the poor — without adopting reforms that would help hold down those costs — is a puzzling solution to a vexing budget problem. So naturally the House and Senate on Friday ran with it.
Under the compromise budget now awaiting action from Gov. Charlie Baker, Massachusetts employers would be required to pay a higher health care assessment (up from $51 per employee per year to $77). In addition, companies whose workers enroll in MassHealth or a subsidized private insurance plan would be required to pay a fee, up to $750 per worker. In all, the new assessments are expected to generate $200 million in revenue.
There has been general agreement that employers would be asked to dig deeper to help address the soaring cost of providing coverage to low-income people. But in their final budget, lawmakers decided to adopt the revenue side of the deal — while ignoring a series of reforms intended to spread the cost burden.
Some lawmakers argued Baker’s reform proposal came too late. The lead Senate budget negotiator, Sen. Karen Spilka, said the reforms need to go through “the proper process.”
But that is laughable excusemaking, from the same people who negotiated the final budget entirely in secret, and called for a vote less than six hours after releasing it to members. That’s transparency?
No, their real beef is with the reforms themselves, which might require some Medicaid enrollees to contribute more of the cost of their coverage, or transfer to a (subsidized) commercial plan.
The budget holds down a scheduled increase in unemployment insurance rates, but that doesn’t address the Medicaid cost drivers. And business groups are alarmed.
“On its own, the employer assessment negatively impacts thousands of businesses around the state. That impact is only acceptable as one part of a broader package that begins to address underlying health care costs,” a coalition of seven employer groups wrote in a letter to lawmakers Friday.
We thought legislative leaders understood this. Their actions say otherwise.