In 2014, the federal government will send hundreds of millions of dollars to Massachusetts to help pay for an expansion of Medicaid under the terms of the Affordable Care Act. How we use those Medicaid funds will influence whether the state will have the financial resources to sustain that expansion over time.
The first step in assuring the Medicaid funds are spent properly and as intended by Congress is to segregate them from the general funds of the state. This should be done by placing the new Medicaid revenues into a trust fund that would be dedicated to support Medicaid and other low-income health care programs. It is an idea that makes sense to many consumer, labor, business, and health care leaders.
Health insurance base rates will rise an average of 2.5 percent for Massachusetts small businesses and individuals renewing their policies July 1. The increase is slightly smaller than the 2.7 percent average base rate hike for policies renewed in the current quarter.
The new third-quarter rates — affecting more than 147,000 people — approved by the state Division of Insurance all fell within the cap established by the Patrick administration as part of last year’s health cost containment legislation. The law ties health care spending to the state’s economic growth, projected at 3.6 percent this year.
In addition to the base rates, however, many employers have to pay more because of heightened risks associated with their industry, location, or average age of their workforce.
Regulators approved base rate hikes of 3.6 percent for Blue Cross Blue Shield of Massachusetts, the state’s largest health insurer, and its HMO subsidiary. The increases were 1.4 percent for Harvard Pilgrim Health Care and 2.8 percent for its HMO arm. Base increases were 3.5 percent for Tufts Health Plan and 3.6 percent for its HMO business. The insurance division said rates for Fallon Community Health Plan were still being reviewed.
Healthcare puts Jerry Brown, Capitol Democrats on different sides
The Democrats who control the Legislature want to make it easier to obtain public insurance than Brown does and send more money to doctors, hospitals and counties than the governor wants to part with.
By Anthony York and Chris Megerian, Los Angeles Times
7:10 PM PDT, May 10, 2013
SACRAMENTO — With California's deficit wiped out and its economy starting to hum, this was to be a year when Gov. Jerry Brown was free of the budget logjams that have paralyzed the Capitol.
But instead, the governor has a fight on his hands — with his fellow Democrats. He is on a collision course with them over how to reshape the state's sprawling, complicated healthcare system to conform with President Obama's national overhaul.
The sticking points in extending public healthcare to more Californians include how many to add to state insurance rolls, how much to pay doctors and hospitals, and how much money to give counties for their care of the indigent.
The
Democrats who control the Legislature — with a veto-proof supermajority — want to make it easier to obtain public insurance than Brown does and send more money to the doctors, hospitals and counties than the governor wants to part with.
Lawmakers have been pressing Brown administration officials for more information in legislative hearings, making clear that they find the governor's plans lacking. The strains underscore the divisiveness of healthcare issues even in a state that has moved aggressively to implement President Obama's signature legislative achievement.
The dispute is growing increasingly tense as the governor prepares to release his revised budget blueprint Tuesday. The new plan will trigger the Capitol's most intense spending negotiations this year, resulting in the budget that is due to take effect July 1.
Despite opposition from the administration, a handful of bills are moving through the Legislature. The lawmakers are bolstered in their position by a coalition of activists and county officials alarmed by the administration's call for a more restrained healthcare expansion than they say is needed.
"Everyone is on the same page," said Assemblywoman Holly Mitchell (D-Los Angeles), who chairs a subcommittee on health and social services. "It's the governor who seems to be out of the loop."
The major bill that would expand public insurance under Medi-Cal is from Assembly Speaker John A. Pérez (D-Los Angeles). The measure would make it easier for Californians to enroll in the program by allowing people to sign up online and eliminating requirements that recipients file semiannual financial reports to prove they are still eligible.
Administration officials have said the governor opposes those changes out of concern that the easier enrollment process could lead to fraud.
Democratic and Republican lawmakers alike want to reverse some of the cuts made in recent years in how much the state reimburses doctors and hospitals who treat the poor — as many as 4 million of whom could remain uninsured. Legislation to reimburse the providers about $1 billion more annually has passed a Senate committee with unanimous, bipartisan support.
http://www.latimes.com/health/la-me-brown-healthcare-20130511,0,5891530,print.story
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