The Massachusetts House overwhelmingly approved its version of
legislation designed to cut the cost of medical care, passing the
measure 148-7 after a full day of debate on June 5th. After it
initially released a bill on May 4th
(see our prior alert), House leadership, including the original
author, Representative Steven Walsh, accepted feedback and
recommendations from various stakeholders. A minimally revised bill
emerged from the House Ways & Means Committee on May 30th and
House legislators then offered 275 amendments to that updated
version.
One noteworthy provision included in the House Ways
& Means Committee redraft bill would double the number of
patients who can join an accountable care organization to 800,000,
a change that would provide some relief for large networks. The
redraft also places the independent authority that would set
guidelines and monitor compliance envisioned in the original
legislation under the Executive Office of Health and Human
Services. House leaders say the bill will save our state health
care system $160 billion over the next 15 years.
This week the House disposed of all 275 amendments
in one day of debate but did not make significant changes to the
provisions proposed in the original bill.
Highlights of the Floor Debate
Rejection of an amendment that would have eliminated the
mandate in the bill that capped medical spending at a rate below
the gross state product;
Rejection of amendments that would have expanded the excise tax
on cigarettes to other tobacco products, and eliminated the sales
tax exemption on soda;
Adoption of an amendment that would require accountable care
organizations to serve children with specialty care needs;
Rejection of amendments that would have eliminated the
so-called luxury tax and the surcharge on providers and
insurers;
Adoption of an amendment that would have allowed small
businesses to reduce their fair share assessments by excluding
employees who have qualifying coverage from a spouse, parent,
veterans' plan, Medicare or Medicaid;
Adoption of an amendment that includes accountable care
organization in the listed entities, as it pertains to unfair
methods of competition;
Rejection of an amendment that would have required health plans
to offer a basic health plan devoid of coverage mandates; and
Rejection of an amendment that would have created a task force
to review health care executives' compensation and
bonuses.
The House and Senate bills
(see our previous House and Senate alert) contain key
differences, most notably over how much discretion and control the
health care industry itself may have to contain costs. The House
favors more oversight, albeit with a limited number of appointed
boards, whereas the Senate approach allows for more leeway in the
development of solutions to reduce and control costs but arguably
creates more bureaucracy to monitor it. Senate President Therese
Murray has also been clear that she will not support a luxury tax
on hospitals.
What's Next?
The House and Senate will appoint a six member
conference committee in the coming days to negotiate these
legislative differences. Ultimately, the House and Senate must give
an up-or-down vote on the conference committee's report and
deliver that final product to Governor Patrick prior to the
conclusion of the current legislative session on July 31st.
ML Strategies will monitor the work of the
conference committee and provide updates as the legislation
progresses.
The content of this article is intended to provide a general
guide to the subject matter. Specialist advice should be sought
about your specific circumstances.
Specific Questions relating to this article should be addressed directly to the author.
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