House and Senate lawmakers delivered a state budget to Governor Deval Patrick on Thursday that loosens a ban on gifts from drug companies to doctors, tightens rules for welfare recipients, and includes provisions to crack down on illegal immigrants.
The bill reflects the melding of earlier versions of the budget passed by the House and Senate and will be subject to possible vetoes by Patrick. The governor’s budget chief, Jay Gonzalez, released a statement praising lawmakers for approving changes Patrick had sought in the oversight of community colleges, but saying the rest remains under review.
The $32.5 billion blueprint for the budget year that begins Sunday includes no new taxes or fees, and reverses some of the cuts most feared by social services advocates. It keeps Taunton State Hospital open with 45 beds, rejecting Patrick’s plan to close the mental health facility and move its patients to a new hospital in Worcester.
It also provides the first raise in five years for 31,500 direct care workers who assist people with disabilities and who earn less than $40,000 a year. They will get a 1.5 percent to 2 percent raise, a modest bump for workers with starting salaries of about $12 an hour.
“It’s a historic moment that they have been recognized by the Legislature as deserving of this support,” said Michael Weekes, chief executive of the Providers’ Council, an association of health and human service agencies that lobbied hard for the $20 million needed to fund the raises.
The budget restores some dental benefits to 800,000 Medicaid recipients in Massachusetts who lost dental coverage, except for cleanings and extractions, in a budget cut three years ago. The new plan extends insurance coverage for fillings in the front teeth, but not the back teeth, and not for dentures or crowns.
Brian Rosman, research director of the advocacy group Health Care for All, said lawmakers decided to extend coverage to only front teeth because they believed those teeth are most important when Medicaid recipients are applying for jobs. “It’s a halfway measure, and we strongly think all dental benefits should be restored,” Rosman said.
Following the recent high-profile arrests of welfare recipients accused of fraud, lawmakers banned recipients from using Electronic Benefit Transfer cards to buy alcohol, lottery tickets, tobacco, pornography, jewelry, and tattoos, among other items.
They also prohibited liquor stores, casinos, strip clubs, gun shops, manicurists, cruise ships and rent-to-own stores from accepting the cards.
Critics of the EBT program had sought to ban welfare recipients from using the cards to withdraw cash. But lawmakers opted instead to set up a commission to study a cashless payment system.
Representative Shaunna O’Connell, a Taunton Republican and leading EBT critic, said she was pleased with the changes, but added: “If we don’t deal with the fact that people can access all this cash, the rest of the reforms will be virtually meaningless.”
Deborah Harris, an attorney at the Massachusetts Law Reform Institute, which advocates for welfare recipients, said the changes were not about reducing fraud. “This is about micromanaging what eligible families can do with the benefits they are poor enough to qualify for,” she said.
In an effort to target illegal immigrants, lawmakers approved stiffer penalties for driving without a license and knowingly employing an unlicensed driver.
But they scrapped a Senate proposal that would have required anyone doing business with the state to verify their workers are in the country legally. Critics argued the requirement would burden businesses with red tape.
The budget also drops a Senate plan that would have required all residents in public housing to prove they are in the country legally. Critics contended the rule would break up families who include legal and illegal residents.
“We’re very pleased,” that the bill protects “the interests of all the residents of the Commonwealth,” said Eva Millona, executive director of the Massachusetts Immigrant and Refugee Advocacy Coalition, which opposed a tough crackdown.
Republicans said they, too, were pleased that the budget targets illegal immigrant drivers. “Unlicened drivers continue to pose a serious public safety threat to all law-abiding citizens,” said Senate Minority Leader Bruce E. Tarr.
The budget weakens a 2008 state law that forbids drug companies from giving gifts to doctors. It allows drug companies to pay for “modest” restaurant meals for doctors, as long as those meals are part of an informational briefing. State regulators will have to define “modest.” Drug companies will also have to report their spending to the state.
The hotel and restaurant lobbies fought hard for the change, arguing the ban was hurting business. House Speaker Robert A. DeLeo said some restaurants reported losing 20 percent of their sales after the ban passed three years ago.
Rosman, of Health Care for All, criticized the change. He said restaurant meals funded by drug companies encourage doctors to prescribe more costly brand-name medications. Medical decisions should be based on “objective information, not fancy meals,” he said.
Lawmakers left intact a ban on drug companies paying for doctors’ junkets on cruise ships and tickets to sporting events.
Addressing concerns about poor coordination among community colleges, lawmakers approved changes that Patrick sought to strengthen his role in running the schools. The changes allow the governor to appoint the board chairs of community colleges, and require the state to develop rules for the selection, evaluation, and removal of community college presidents.
Responding to outrage over the $50 million annual pay for Liberty Mutual’s chief executive, the budget also requires mutual insurance companies to disclose the pay for top executives and board members. But lawmakers struck a measure that would have given policyholders a vote on pay and required directors to be independent.
Michael Levenson can be reached at firstname.lastname@example.org. Follow him on Twitter @mlevenson.