A very interesting ACA development is taking place in Massachusetts today as the state that “inspired” Obamacare tries to reconcile its current law with the new federal law. Push back in the compliance effort is coming from an unexpected source, the senior Democratic budget writer in the State Senate, Senator Stephen Brewer, presumably with support from the Senate President as well. The amendment that was filed would force President Obama’s good friend Governor Deval Patrick (D), and his Administration, to seek a waiver from certain elements of Obamacare. The move could come to a head if the provision lands on the Governor’s desk, resulting in an embarrassing political moment for the Obama Administration since the ACA is forcing significant changes to a state law they claim acted as a model in Washington.
Turns out, the conventional wisdom comparing Romneycare and Obamacare has proven to be overly simplistic, as this is the third ACA-related bill being debated in the Commonwealth. The latest sizable 100-section bill controversially writes into law an abdication of insurance regulation to the federal government and is the basis for the amendment. While state officials have known for some time that the ACA-required changes to rating factors would result in “extreme premium increases” and spike premiums for 60% of small companies (some as high as 50+%) in the state, the best the Patrick Administration could do was spread the increases out over 3 years under an agreement from CMS.
The new ACA bill produced a flurry of debate in the House last week, mostly from the Republicans, with Democrats calling it a bill of “minor technical changes.” However, in the State Senate the bill faces a surprising push back from the lead budget writer and a long serving Democrat, as numerous questions remain about the bill. See my 10 Questions About ACA Implementation in Massachusetts.
The chairman’s amendment includes the following:
SECTION 102A. The commonwealth, by and through the governor or the governor’s designee, shall formally request a federal waiver to avoid the adverse effects of rating and rule changes to the Massachusetts merged market, to protect consumers and businesses in the commonwealth and in an effort to maintain current Massachusetts rating and rule requirements. All negotiations with any federal agency concerning this waiver shall be conducted in consultation with a member of the house of representatives as appointed by the speaker of the house and a member of the senate as appointed by the senate president. The governor, or the governor’s designee shall file a detailed report describing the waiver application and waivers received, along with all documentation, including, but not limited to, all related written and verbal responses from the Department of Health and Human Services, with the clerks of the senate and house not later than October 1, 2014. The governor shall report monthly to the joint committee on health care financing and the house and senate committees on ways and means on the status of the waiver request under this section.