MHA Weighs In On House Budget

With the Massachusetts House’s budget proposal for FY18 expected to be filed the week of April 10, MHA has been on Beacon Hill advocating for a number of priorities on behalf of the hospital community.

After Governor Charlie Baker filed his budget proposal in January, MHA weighed in with a pointed letter highlighting strong opposition to the governor’s plans to impose direct government regulation of provider payments in the commercial insurance market, including growth caps on commercial payments to providers, limitations on contracts covering Group Insurance Commission members, and a directive to eliminate facility fees.

In a letter to House Ways & Means Chairman Brian Dempsey (D-Haverhill) this month, MHA reiterated its opposition to those proposals but focused its attention on other budget priorities related to the Health Safety Net (HSN) and MassHealth program.  MHA advocated for strengthening the financing of the Health Safety Net, including the restoration of $30 million in state funding for the program. Despite a statutory directive requiring the state to invest $30 million in the HSN, the governor’s proposal did not include any state funding.  The safety net has been in a constant state of shortfall for many years, including FY2016 which ended with a $109 million shortfall. Hospitals alone bear the burden of all shortfalls, in addition to the assessment they pay to fund the program.

MHA also urged for the legislature to restore enhanced Medicaid payments to Disproportionate Share Hospitals (DSH) in recognition of the large numbers of low-income patients cared for by these facilities. Although such payments were included in the FY2017 budget, hospitals learned shortly after its passage that MassHealth would be eliminating the FY2017 DSH supplemental payments through changes in payment methodology.

Another priority MHA cited is to ensure post-acute hospitals receive additional Medicaid funding now that they will be paying a new annual assessment under the governor’s budget.

Recognizing the great uncertainty that remains about the future of federal Affordable Care Act funding in light of the sustained efforts to repeal key provisions of the law, and stressing the continuing pressure on Massachusetts given inadequate MassHealth payment levels, MHA’s letter to Dempsey noted, “The continuous path of cutting provider reimbursement to cover the costs of expanding MassHealth enrollment is not a viable long-term path and is weakening providers while endangering access to needed services. We hope that we can work together to secure a solid foundation for existing program funding and operational processes so that any payment and delivery reforms will be successful for patients, healthcare providers, and the commonwealth.”