Time to take medicine

Democratic lawmakers raised a host of concerns about Gov. Charlie Baker’s proposed reforms to the MassHealth program, including uncertainty over changes to health care policy that might come out of Washington.

But without that excuse they would have found something else. Beacon Hill is hungry for the $200 million in new employer assessments that Baker proposed, as a way to offset higher health care costs that have blown a crater in the state budget. But they have little interest in embracing the reform side of the equation.

At a hearing Tuesday we heard the usual complaints, that the poor would suffer under Baker’s plan.

That ignores the fact that his main reform would involve moving 140,000 adults — nondisabled, non-elderly — from the MassHealth program to commercial insurance plans with comparable coverage, for which they would still pay no premiums. They would have slightly higher out-of-pocket costs (co-payments, for example, and new costs for dental coverage). But most of the cost of their care would still be paid for by taxpayers.

Senate Ways and Means Chair Karen Spilka said Tuesday there “may be other ways to do savings” than what Baker has proposed.

But pray tell the taxpayers, what are the “other ways”? Where is the Democrats’ plan?

This isn’t a theoretical problem, after all. MassHealth accounts for 40 percent of state spending. Enrollment has grown by 70 percent over the past decade (slowing only after the Baker administration introduced new efficiencies). Without the reforms, MassHealth spending is expected to grow by an additional $340 million this year, requiring cuts in doctor reimbursements and elsewhere in the budget.

In the absence of the reforms the governor could veto the employer assessments, though it would cancel out $200 million in revenue needed to fund MassHealth and make a bad budget situation worse. The inevitable anger from the business community should be pointed directly at Beacon Hill Democrats.