Even with the previously proposed federal Republican healthcare bill now out of the picture, concerns remain in Massachusetts over rising healthcare costs in the state.
“It’s a complicated thing—there is no easy answer to this,” said Senator Viriato M. (Vinnie) deMacedo, (R-Plymouth). “We have the finest health care in the nation, but also the most expensive health care in the nation.”
With expansion of Medicaid under the Affordable Care Act, commonly known as Obamacare, more Massachusetts residents have turned to MassHealth for coverage.
But the increase in participation is taking a financial toll on the commonwealth.
“We’re struggling to close a $600 million hole this fiscal year,” state Representative Randy Hunt (R-Sandwich) said.
Massachusetts had been a leader in promoting health care for all its residents before the Obama administration rolled out the Affordable Care Act in 2009.
At the time, Massachusetts already had what was commonly called Romneycare, an initiative of then-Governor W. Mitt Romney, which was established in 2006.
At present, only 2.8 percent of the state population is uninsured, the lowest percentage in the country, according to US Congressman William R. Keating. Mr. Keating represents the Ninth Massachusetts District, which includes Cape Cod.
Rep. Hunt estimates that 2 million people, or one out of every three people in Massachusetts, are on MassHealth. The numbers have increased by 7 percent with the expansion of Medicaid, which was funded under Obamacare with support from the federal government.
Medicaid principally serves lower-income Americans and some handicapped Americans.
Small businesses are also feeling the pressure from rising health insurance costs for employees. Mr. Hunt said those costs have risen 150 percent to 200 percent in the past five years.
These businesses could be further affected by an employer assessment plan proposed in Governor Charles D. Baker’s Fiscal Year 2018 budget, which would take effect July 1. Businesses with less than 80 percent of their employees insured under company plans could pay a potential penalty of $2,000 per employee.
The idea is that this revenue could fill in the gap created by rising Medicaid costs. But Mr. Hunt said the plan’s potential impact on small businesses has created controversy.
Some analysts have said community health centers can help offer a solution to rising healthcare costs in the state.
Their clinical model, which integrates a range of in-house services such as general care, mental health and dentistry among others, lends itself to keeping costs low. Offering these services under one roof results in more efficient patient care, such as avoiding the costs of duplicate testing.
Karen Gardner, chief executive officer of the Community Health Center of Cape Cod in Mashpee, said that community center costs are 24 percent less, on average, than other providers.
“We make extremely good use of our dollars and can provide high quality care,” Ms. Gardner said. “We can put all the pieces together to have a better outcome and keep people out of the hospital and ER.”
The Mashpee community health center has approximately 13,000 registered patients. About 44 percent are on MassHealth (subsidized care), 23 percent are on Medicare, 28 percent are on private insurance and 5 percent are uninsured.
Sen. deMacedo said that obtaining health care from local providers saves costs in an additional way. Patients often will travel to the larger hospitals in Boston for care, where costs are two to three times higher than community hospitals.
“Outcomes are the same, but costs are high,” the senator said.
Maintaining strong federal support continues to be important in keeping the state’s healthcare program strong.
In March, Mr. Keating spoke about programs his district that are dependent on Medicaid funding. Under the proposed GOP federal plan, which was pulled from consideration last month before it could come to a vote, the state would have lost $1 billion in federal funds in 2020.
“Cuts in Medicaid, Mass Health would enormously affect the treatment for addiction,” Rep. Keating said.
Mr. Keating saw a potential local economic impact, given that some of the biggest employers in his district are hospitals that rely on Medicaid funds.
With reports that a revised healthcare bill may be coming from President Donald J. Trump, Mr. deMacedo said that the state needs to keep an open line of communication with the federal government.
“We need to make sure we have a seat at the table and to keep that dialogue open, the senator said. “This is in the best interest of the commonwealth.”
Healthcare Challenges In The State | Falmouth News