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Nov. 18 — Massachusetts won’t reduce health benefits if Donald Trump cuts federal health-care dollars as president, state Attorney General Maura Healey (D) said.
“We’ve had a long and inspiring tradition to keep health care affordable and accessible,” she said. “We have to prevent changes that would harm consumers and employers and harm the vitality of our health-care market,” Healey said Nov. 18 in Boston at a meeting of the Massachusetts Association of Health Plans.
It is possible a Trump administration would cut funds under the federal Affordable Care Act and in Medicaid, the federal-state program that pays for health care for people with low incomes, Healey said.
“We’ve got a shared responsibility to together continue to make health care affordable and accessible,” Healey told the group of health insurers and providers.
Massachusetts embarked on health-care reform in 2006, and put in place a health-care system that became the model for the federal ACA. About 98 percent of residents are insured, though Massachusetts is among the most expensive states in which to buy health insurance in the nation.
Trump and Republican congressional leadership have said they want to repeal or significantly change the ACA, which they believe is flawed.
“Some reports say Congress may act quickly to defund the ACA through the budget reconciliation process. But without a clear alternative ready to go a repeal would leave many people uninsured,” Healey said.
“Defunding the ACA and leaving millions without coverage would be unconscionable. Let me be clear, there are problems with the ACA. But its problems won’t be solved by simply throwing it out,” Healey said.
Healey has been in talks with the federal Department of Health and Human Services about potential changes in health care, she said. “I’ve asked my team to keep a very close watch on the federal playing field and in Massachusetts, including what our options are,” Healey said.
“Our goal is to be ready, ready to respond and adapt to help our businesses and residents,” she said.
Massachusetts is about to overhaul the way it offers and pays for health benefits through Medicaid. The state received permission Nov. 4 from the HHS, called a waiver, to make the changes, and a promise of $52.4 billion in funding over five years beginning in 2017 ( 216 HCDR, 11/8/16 ).
The state plans to ask hospitals and health providers to form into large groups to care for Medicaid patients. The state will pay the groups, called accountable care organizations, one large fee to provide all the care for their Medicaid patients. In this way, the state hopes to phase out the current way of paying hospitals and doctors a fee for every service provided to patients.
The incoming Trump administration may change the Medicaid agreement and reduce the funds, Healey said. Trump has expressed interest in giving states a block grant for Medicaid, rather than using the current funding formula, which is generally more generous.
“We’re an international destination for innovation and creativity. Now is the time to harness it,” she said. “Let’s show the nation what is possible.”
Massachusetts needs to continue to improve its health-care system during the next four years, Healey said. Health care is too expensive in the state and one in five residents is struggling with medical debt, she said.
The state needs to do a better job about making the prices of health-care services and prescription drugs more transparent, she said.
Healey opened her talk by saying her office has received more than 300 calls from people being harassed or bullied or physically threatened by others since Trump won the election. She said she would not keep quiet if Trump policies infringe on people’s human rights.
“Where there are lines crossed and steps taken, whether they are steps taken to affront dignity, or an affront to our concept of liberty and equality and prosperity, I’m going to speak out,” Healey said.
“I think about what people fought for and died for here. The fight for liberty, equality and prosperity. This is an opportunity to stand strong for our values and to speak up for what is right and just,” she said.
Healey may have the support of Gov. Charlie Baker (R) in her zeal to maintain health benefits for Massachusetts residents. Baker told reporters Nov. 16 it is important for the state to continue its commitment to provide universal health coverage.
Mary Mahoney, an attorney with Tufts Associated Health Plans Inc., said there is plenty of buzz among people who work for health plans about changes that may come through the Trump administration.
“Massachusetts has invested so much in health reform. It would be unfortunate if that goes away after so much effort,” Mahoney said during the health meeting.
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