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September 3, 2015

Citing Connector, Baker expects improved health care costs for 2015

Gov. Charlie Baker often resists talking about what has happened in the past or placing blame on the previous administration for problems he's now working to fix, but on Wednesday he had no problem looking backward when assessing a new report that found health care spending in 2014 far outpaced the state's goals for controlling cost.

The Center for Health Information and Analysis on Wednesday released its annual health care spending report that found overall costs grew 4.8 percent in 2014, exceeding the state target goal of 3.6 percent. Increased prescription drug costs and a 19 percent explosion of spending and 23 percent increase in enrollment at MassHealth were cited as the drivers of the spending growth.

"My big takeaway from that report was if the commonwealth of Mass. breaks its Connector and spends hundreds of millions of dollars of taxpayer money without fixing it and has to put hundreds of thousands of people who might not choose to be enrolled in MassHealth into MassHealth on a temporary basis, on an uncontrolled basis, with no real ability to effectively manage eligibility, much less care delivery, you'll probably end up spending a lot more than you thought you were going to spend which was pretty much what happened in 2014," Baker told reporters.

The governor said his administration has been "diligent and persistent in our approach" to fix the Connector Authority's website where people can apply for and enroll in subsidized health coverage, and has finished combing through the more than 300,000 people who were placed in temporary Medicaid coverage in 2014 because they could not enroll through the Connector.

"It is my hope and my expectation that we will have a much better year in '15 as a result of that," Baker said.

While some of the enrollment and spending growth at MassHealth can be attributed to the expansion of Medicaid eligibility under the Affordable Care Act, CHIA reported a portion of the growth was "a result of policies designed to protect Commonwealth residents from potential coverage lapses due to the functional limitations of the joint eligibility system used to determine MassHealth and Connector membership."

Between December 2014 and March 2015, CHIA reported that MassHealth enrollment declined 15 percent, and the administration said it has taken steps to limit Medicaid spending growth in fiscal 2016 to 6 percent, in part by trimming more than 205,000 from the rolls through a redetermination process to check everyone's eligibility.

CHIA Executive Director Aron Boros said in an interview that it is difficult to draw conclusions about how much the temporary Medicaid population contributed to the spike in MassHealth spending because its unclear how many of those people accessed health care during the period they were covered.

"It was just such a chaotic year for MassHealth its hard to draw any clear analytic conclusions," he said.

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