Governor Charlie Baker defended his new health care bill Tuesday, while some in the health care industry began raising concerns about parts of his wide-ranging proposal.
The governor’s bill calls for expanding primary care and mental health care. It also would penalize pharmaceutical companies that sharply raise drug prices, prohibit certain surprise bills, limit the use of hospital facility fees, and regulate urgent care centers, among other changes.
“While many would argue that the fundamental problems with our health care system are rooted in some provider organizations being paid too much, and some being paid too little, we would argue the problem is more fundamental than that,” Baker said in a speech to the state Health Policy Commission.
Community hospitals have long argued they lack the clout to demand higher reimbursements from insurers, and they have lobbied for legislation that would increase their rates.
Baker’s 179-page bill doesn’t directly tackle the issue of hospital price variation. It includes $10 million a year in aid for independent community hospitals — but hospital leaders said that falls short.
Dianne J. Anderson, the chief executive of Lawrence General Hospital, said the legislation “does not address the real core issues of appropriately reimbursing hospitals and providers.”
“It’s probably not enough to be a sustainable fix,” she said of Baker’s bill. “We really do need the actual rate adjustments.”
Dr. Michael Apkon, the chief executive of Tufts Medical Center — which is paid less than other academic medical centers in Boston — said the current payment system creates “a pretty uneven playing field for providers to compete against each other.”
“We would like to see that addressed more directly,” Apkon said.
Some hospital leaders also questioned the feasibility of a central feature of the governor’s bill: a requirement that health care providers and insurers increase investments in primary care and behavioral health by 30 percent over three years, while meeting existing requirements to contain overall spending.
Baker, a former health insurance executive, defended his approach, which demands the health care industry shift from one that values high-end medical technology to one that prioritizes preventive care.
“We have to acknowledge that the nature of illness has changed. Chronic illness is far more prevalent than it used to be. Addiction is far more prevalent than it used to be. Behavioral health issues and mental issues, especially among seniors, are far more significant than they used to be,” Baker told reporters.
“Something’s got to give. This is our proposal on how to make that adjustment. I think it should be able to be done.”
The administration’s health care plan kicks off a complicated debate that is likely to last several months.
It’s now up to the House and Senate to draft their own bills, which could deviate from Baker’s proposal.
Health care is among several big issues lawmakers plan to address before the end of the legislative session in July. They’re also working on an overhaul of the state’s school funding formula and a potential tax package to better fund transportation.
House Speaker Robert A. DeLeo cautioned Tuesday against quick action on a complex issue like health care. He told reporters that he has directed leaders of the House health care committees to “take your time” when drafting legislation.
“We want to try to get it right,” he said.
Last year, the House and Senate tried to find a compromise on a health care bill, negotiating late into the night to try to meet deadline.
But they failed to bridge their differences.
At the time, House leaders wanted to boost community hospitals by charging hundreds of millions of dollars of new assessments on insurers and large hospitals. The Senate, however, wanted to help community hospitals by mandating that insurers pay them more for medical services. (Baker’s proposal excludes both of those ideas.)
“We came extremely close last time,” DeLeo said.
Drug prices also are likely to be a contentious part of this year’s debate.
Robert K. Coughlin, president of the Massachusetts Biotechnology Council, which represents biopharmaceutical companies, said he will urge lawmakers to reconsider Baker’s proposals to curb drug costs.
“I think it’s a step toward price controls,” Coughlin told the Globe.
“And it’s punitive to an industry that’s very important to Massachusetts and extremely important to patients around the world.”