The Legislature’s rejection of Gov. Charlie Baker’s MassHealth savings initiatives represents a big political shift on Beacon Hill. In the past, Democratic lawmakers have largely ceded the nitty gritty of budget balancing to Baker, but Wednesday’s votes suggest they are willing to take a political stand that requires them to step up and find savings elsewhere in the MassHealth budget.
There seems to be consensus that something needs to be done about MassHealth, which provides health insurance for 1.9 million people — 40 percent of the state’s children, 60 percent of disabled adults, 20 percent of individuals over 65, and two-thirds of all nursing home residents. Enrollment numbers keep growing and the program now accounts for 40 percent of the state’s budget.
The Baker administration says it has exhausted efforts to wring inefficiencies out of the “unsustainable” MassHealth system, and now needs to start moving people off of Medicaid and into subsidized commercial health plans. The governor’s biggest initiative would move about 140,000 people earning more than the federal poverty line into health plans that would cost roughly 2 to 3 percent of their income.
Democrats, including the more conservative Democrats that dominate House leadership, balked at the governor’s proposal when he initially pitched it as a last-minute addition to the overdue fiscal 2018 budget and again on Wednesday after he sent it back to the Legislature as an amendment to the budget.
Unlike Washington, where the rhetoric over health care has been harsh, the debate on Beacon Hill has been very civil. Democrats said they wanted more time to study Baker’s proposal and promised to come up with their own savings initiatives that wouldn’t rely on cutting people from the Medicaid rolls.
The closest thing to a political attack came in a CommonWealth op-ed from three Democratic state representatives who accused Baker of trying to have it both ways, opposing Medicaid cuts in Washington while favoring them at home in Massachusetts. “Balancing the budget is an extremely difficult task in this environment, but should not be done on the backs of the working poor,” they said.
Boston Globe columnist Joan Vennochi cast the dilemma this way: To cut spending, how many poor people can you push, in good conscience, from fully subsidized health care to what Baker is proposing?
Baker’s core competency is his ability to manage state government, which includes keeping the budget in balance at a time when revenues are coming in at a pace slower than expected. Now Democrats on Beacon Hill are challenging that core competency, and promising to come up with an alternative approach on MassHealth.
Whether lawmakers can do that quickly and efficiently will be a major test. The Cape Cod Times thinks it’s possible, while the Boston Herald is skeptical. Given the problems the Legislature had in resolving differences on marijuana regulation, skepticism is probably warranted.
–BRUCE MOHL
BEACON HILL
House Republicans and Bristol County Sheriff Thomas Hodgson hold a press conference at the State House to push legislation allowing local police to detain individuals wanted by ICE, but are interrupted repeatedly by immigrant rights advocates who chanted “keep hate out of our state.” (WGBH) Gov. Charlie Baker is also preparing legislation to allow police officers to work with ICE in the wake of a Supreme Judicial Court ruling earlier this week that there is no state law allowing such cooperation. (State House News)
Lawmakers kick the can on horse racing. (CommonWealth)
MUNICIPAL MATTERS
Boston’s fire commissioner ripped construction workers who waited 90 minutes after starting to smell smoke before calling the fire department to a Dorchester condo complex that was destroyed in a massive blaze earlier this month. An improperly positioned vent pipe was the likely cause of the fire, officials say. (Boston Herald)
Milton selectmen have set a special town meeting date for October to consider a ban on retail marijuana shops. (Patriot Ledger)
WASHINGTON/NATIONAL/INTERNATIONAL
A second Senate vote to repeal the Affordable Care Act fails as Republicans turn to the idea of a “skinny repeal” that would leave most of the law in place but strip out the individual mandate to buy coverage and a tax on medical devices. (Boston Globe)
President Trump announces, via three tweets, a ban on transgender individuals serving the military, setting off a bipartisan backlash of condemnation. (New York Times) Joe Battenfeld says Trump needs to stop veering off course with things like the ill-considered directive. (Boston Herald) Attorney General Maura Healey says Trump’s comments make him “unfit to lead” the country. (MassLive) WBUR reports on the Massachusetts congressional delegation’s response to Trump’s tweets.
Trump cited medical costs associated with transgender soldiers as the primary driver of his decision, but the Washington Post reported that the military spends more on erectile dysfunction drugs than it does on transgender care.
Conservative New York Times columnist Ross Douthat says, “This president should not be the president.” He cites Trump’s campaign against his own attorney general as the latest evidence for that, calling Trump “clearly impaired” and “gravely deficient somewhere at the intersection of reason and judgment and conscience and self-control.”
ELECTIONS
Longtime Republican operative Beth Lindstrom says she’s considering entering the Republican race to take on Democratic Sen. Elizabeth Warren next year. (Boston Globe)
Herald News columnist Mike Moran wonders why businesses in Fall River adorn their storefronts with campaign signs — turning off potential customers who support an opposing candidate.
BUSINESS/ECONOMY
Total Wine & More won a pricing dispute with the Alcoholic Beverage Control Commission, as a judge says the retailer wasn’t illegally selling liquor below cost because its prices included discounts it received on volume purchases. (Metrowest Daily News) The retailer and the Massachusetts Package Store Association recently traded fire over Total Wine’s pricing practices in dueling CommonWealth op-eds.
The Boston teenagers who uncovered a 1993 law the owners of TD Garden never complied with, which required them to hold at least three fundraisers per year to fund area recreation programs, say the Garden owes at least $13.8 million. (Boston Globe)
Florida stopped offering financial subsidies to Hollywood producers to film there and many productions decamped for elsewhere, so cities like North Miami are starting to offer their own incentives. (Governing)
EDUCATION
Lawmakers are close to repealing the “English-only” state education law passed by voters 15 years and allowing the return of bilingual classes. (Boston Globe)
“School choice” has become a third-rail issue, never more so than under Trump education secretary Betsy DeVos, but edu-thinker Andrew Rotherham says choice has a long and nuanced history that today’s debate does not capture. (U.S. News & World Report)
HEALTH/HEALTH CARE
Massachusetts hospitals are seeing a surge in opioid-related visits, particularly from young people. (South Coast Today)
Berkshire Medical Center nurses authorize their union to call a one-day strike. (Berkshire Eagle)
CRIMINAL JUSTICE/COURTS
Austin Reeves’s ex-girlfriend made calls to the Weymouth police saying he threatened to kill her new boyfriend and kill himself and that he had a gun hours before a standoff earlier this month with SWAT team officers that ended with Reeves killing himself at his parents’ Hingham home. (Patriot Ledger)
A Florida parole board rejected former FBI agent — and Whitey Bulger “handler” — John Connolly’s petition for release and a set a new parole date of 2039, when he would be 98. (Boston Herald)
A Sandwich woman is arrested for threatening an officer in a topless road rage incident. (Cape
Cod Times)
CommonWealth should do more than highlight the failure of Delaware North to follow the law authorizing construction of the arena replacing the Boston Garden. That corporation has reaped one too many windfalls in its dealings with government entities from its North Station parking garage bonanza to not meeting its development obligations around the new Garden and getting out of making $3.5 million in annual payments to benefit city recreation centers in exchange for its new Garden. How is it Jeremy Jacobs, owner of the Boston Bruins and chairman of Delaware North, can work deals that rain taxpayer benefits on his holdings but local public schools can’t even get the state to meet its own financial obligations under the 1993 Education Reform Act?
The reason “edu-thinker” Andrew Rotherham focuses his commentary on the “long and nuanced history” of school choice rather than recent academic results of school choice is too many studies show vouchers aren’t what they’re cracked up to be. The reality is “school choice” only becomes an issue when local public schools are underfunded.