Opinion | Stan Rosenberg and Jim Welch

Fixing health care the right way

Boston Ma 02/25/2017 Deborah Finn (cq) was at a rally with Health Professionals from Massachusetts General Hospital and others to support the ACA at the State House. She is a patient who likes the healthcare she receives. Jonathan Wiggs /GlobeStaff) Reporter:Topic
Jonathan Wiggs/GlobeStaff/File
Health professionals rallied at the State House in February.

Massachusetts has consistently been a national leader in improving health care access and working to address high health care costs. We were the first state in the nation to provide near universal insurance coverage through health care reform legislation passed in 2006 and continue to pursue solutions to help drive costs down, such as those contained in legislation passed in 2012. These steps are a testament to the fact that, as a Commonwealth, we are willing to think creatively and boldly to achieve a health care system that works for all our residents.

But there is a great deal of uncertainty and instability in health care due to changes being considered at the federal level that would result in higher costs for seniors and children with disabilities, a loss of federal revenue for the state, and a reduction in payments for health care providers. It’s unclear how such changes will impact the state’s ability to deliver on its goal of universal access to quality, affordable health care. Without regard to what’s happening in Washington, Massachusetts needs to continue to innovate and create a sustainable health care system for both our residents and our economy. Health care costs currently strain not only the state’s budget, but also those of our businesses and families.

Two weeks ago, Governor Baker put forward a significant package of changes to the state’s MassHealth program, the broader health insurance market, and certain care delivery systems. The governor requested that the six legislators negotiating the Fiscal Year 2018 budget adopt this entire package just as negotiations were wrapping up, and mere days before the new fiscal year began. The governor’s proposals represent some creative thinking; however, in order to accomplish meaningful health care reform, all stakeholders need to be at the table and the most diverse set of options should be considered. A broader conversation ensures that short term fixes are not overvalued at the expense of the long term sustainability of our health care system. We believe this broader conversation must address the drivers of health care costs, not just change eligibility benefit levels and move people from one program to another.


The Senate recognizes the need to address these fundamental challenges and believes that passing comprehensive health care cost containment this legislative session is important. For the last year, the Senate has been engaged in extensive preparation to undertake this work. A group of senators, with the help of the Milbank Memorial Fund, has been conducting ongoing research with other states to learn best practices on how to address significant cost drivers. Additionally, pursuant to legislation that was passed last year, the Legislature engaged with various stakeholders to produce recommendations on how to address certain provider pricing issues in the Commonwealth that contribute to inefficiencies in our health care system.

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The Senate even took a first step to implement some of those recommendations through the inclusion of out-of-network billing reform in its budget. The Senate has also remained focused on managing MassHealth costs by including a provision in the final Fiscal Year 2018 budget sent to the governor’s desk that requires the Massachusetts Health Connector to explore how it could create a premium sharing program for small businesses with MassHealth eligible employees.

The proposals that the governor introduced at the tail end of the budget process are an important part of this ongoing conversation. While welcome, those contributions should be part of a broader dialogue that engages the full spectrum of stakeholders in a robust discussion that moves along relatively quickly but thoughtfully. Massachusetts’ health care sector is one of our five largest industries, supporting the financial, physical, and mental well-being of communities across the Commonwealth. This sector is faced with complex issues that require thoughtful and meaningful solutions. We look forward to working with the governor, the House, the public, members of the health care sector, and all other stakeholders to engage in an open and productive exchange of ideas to develop meaningful reform legislation this session.

Stan Rosenberg is president of the Massachusetts Senate. Jim Welch is a state senator from West Springfield.