House Budget Provides Support for DSH and Safety Net

The Massachusetts House Ways & Means Committee, chaired by Rep. Jeffrey Sánchez (D-Mission Hill), released its proposed FY19 state budget last Wednesday, and a preliminary review of it shows that the budget writers were responsive to some key hospital priorities.

For instance, the committee’s proposed budget requires a $15 million transfer from the Commonwealth Care Trust Fund to the Health Safety Net program – a long-standing MHA priority.  Previous budgets were passed with language indicating that “up to” $15 million may be transferred. That permissive phrasing resulted in no transfer occurring in the past three fiscal years.

The Ways & Means budget also includes a provision to adjust both inpatient and outpatient reimbursement rates for disproportionate share hospitals (DSH). Under the Baker administration’s budget proposal,  DSH hospitals may have received a supplemental payment that totals $13 million. The House approach includes the payment adjustment within actual reimbursement rates – which protects the needed enhancements from the vagaries of state revenue fluctuations and potential mid-year budget cuts. The higher level of certainty that the payments will actually be made, allows the safety net hospitals to factor the payments into patient care delivery and hospital operations.

Ways & Means rejected a proposal in the governor’s proposed budget that would have required about 140,000 people enrolled in MassHealth to get their insurance through the Connector. MHA had supported the governor’s plan with the proviso that certain statutory protections be created to ensure that those being shifted to the Connector would be able to afford their coverage.

Five outside sections in the House Ways & Means budget create an Office of Health Equity within the Executive Office of Health & Human Services to assist in reducing and eliminating disparities in healthcare access and outcomes related to racial, ethnic, and disability status.

The House Ways & Means budget supporting documents indicate that substance use disorder funding has been increased by $37 million over FY2018.