Mass House Pulls a “Charlie Brown” on Payment Reform Redraft

The Massachusetts House rushed the release of their payment reform bill to beat the Senate the first time around. As a result, the next few weeks provided time for House lawmakers to receive feedback and improve the bill before it was to be voted on.

Unfortunately, the bill’s authors missed the ball again, and made only small changes.

Unfortunately, the House has decided to follow the Senate precedent of rushing passage of the final bill. 48 hours to file amendments, and only a couple more days before it is debated and voted on next week. [Changing 18 percent of our economy in two days, with many unanswered questions about added costs, lack of evidence of savings, and lots of new mandates, no problem.]

The legislative process in both chambers has sent a strong signal that the real debate is being saved for the conference committee process. In an all too familiar situation, select House and Senate members will convene behind closed doors to make the real decisions on what will be included in the final legislation. Lobbyists on your marks!

Regardless of the ultimate language in the bill, the proposal still misses the mark for 5 reasons:

1. It is built on unrealistic savings estimates. (video)
2. It trusts bureaucrats to lead the health care market. (video)
3. It adds significant costs to the health care system with surcharges, fees, penalties, reporting requirements, additional Medicaid reimbursements, etc, etc.
4. It puts tremendous faith in unproven ACOs, and alternative payment methodologies. (video)
5. Most importantly, it sidesteps the only long-term sustainable solution to health care cost increases, full engagement of consumers.

Finally, just to complicate matters, the House Ways and Means committee also pulled out a surprise supplemental budget this week that contains numerous health care related provisions. Many pertain to the Connector and changes for Massachusetts in order to be in compliance with ACA mandates. One is left to wonder why the bill is moving now with a looming Supreme Court decision in one month that could make these changes moot, and all the while a 200 page payment reform bill sits on the table?