AP NEWS

Rep. McGovern Pushes Single Payer As Home State Weighs Reforms

February 20, 2019

By Michael P. Norton

STATE HOUSE NEWS SERVICE

BOSTON -- As state lawmakers eye another run at health care reforms aimed at helping community hospitals and enabling scope of practice changes while preserving the existing system’s framework, 2nd District Rep. James McGovern is looking to overhaul the entire health care system.

Worcester’s McGovern is working this week to add signatures to a nationwide single payer health care petition he is circulating with Rep. Suzanne Bonamici of Oregon “to get America moving in a better direction and ensure coverage for every last person living in America.” The congressman is getting help from groups like the Courage Campaign, Daily Kos, Left Action, Medicare For All PAC, and Progressive Democrats Of America.

“It’s time for a health care system that prioritizes health care for all Americans - not the profit margins of corporate giants,” McGovern wrote in an email Wednesday, asserting that a single payer system ensures “access to affordable health care and prescription drugs, doctors and nurses that care for patients, not fight with insurance companies,” and “an end to skyrocketing health care costs that crush small businesses and entrepreneurs.”

It’s unclear whether the U.S. House will pass a Medicare for all bill, which would be viewed dimly by the Republican-controlled Senate. But a House vote, in concert with the traction the issue is getting among Democrats running for president, would give momentum to the cause and may have electoral ramifications. House Speaker Nancy Pelosi said early this year she supports hearings on Medicare for all, which could take place in front of McGovern’s committee, but has not committed to holding a vote.

While debated for years, the idea of a single payer system has not been adopted in McGovern’s home state, where lawmakers and Gov. Charlie Baker are talking about revisiting health care laws this session, but working within the framework of a system backstopped by private insurers and the MassHealth program.

As McGovern, the new U.S. House Rules Committee chairman, knocks the “political stranglehold of the for-profit health care industry,” the Health Care Financing Committee on Beacon Hill this session will be led by new chairs, Rep. Jen Benson of Lunenberg and Sen. Cindy Friedman of Arlington. Health insurance is a requirement under a 2006 state law, leading to a high insured rate, but families, businesses and employers continue to struggle with costs.

Since 2006, costs have continued to grow and the state’s massive MassHealth program has grown to consume about 40 percent of all state spending. -- Per capita health care spending in 2017 was $8,907, according to the Center for Health Information and Analysis.

BENSON

“I think right now we’re focused on universal health care access and that’s what we need to be continuing to strive for here in Massachusetts. We have to make sure costs are contained and there’s still a lot more we can do around that,” Benson told the News Service following her appointment last week.

Benson added, “As far as Medicare for all, I think there’s a big federal conversation happening around that and I think that’s the right place for it. I think right now we have a very vibrant and robust health care system here in Massachusetts that we need to not only protect and maintain but make sure it’s accessible to everyone.”

Before House-Senate talks collapsed last year, lawmakers were pushing to impose new assessments on insurers and larger hospitals and to share new revenues with community hospitals. Gov. Charlie Baker, who this session has outlined plans to rein in prescription drug costs, last year said lawmakers struggled over how to stabilize the finances of community hospitals.

House Speaker Robert DeLeo last October said he was disappointed that consensus was not reached on a health care bill, and said “we will not give up.”

“This coming legislative session, the House will try again,” DeLeo pledged at a hearing on health care costs. “Despite our success at slowing spending growth, we know that patients are still forgoing care due to costs. Our community hospitals and our health centers are still struggling to survive.”

Last Friday, during a speech in Salem, DeLeo said Massachusetts has “maintained our reputation as the epicenter of health care innovation and excellence,” but also used nearly the same words as he did last year to describe the continuing struggles of patients and community hospitals.

“Our businesses are still making tough choices to ensure that they are providing adequate coverage to their employees, as health care becomes a larger part of their bottom line,” DeLeo added, according to the text of his remarks. “We are committed to revisiting issues we talked about last year.”

Baker last year said his administration stood ready to work with lawmakers and others to reach an agreement, noting “a tremendous amount of time, effort, energy, conversation, discussion, and reams and reams and reams of trees” were sacrificed in last session’s health care talks.

Benson suggested the time and energy used last session will help lawmakers to avoid a full restart.

“We’re going to start by looking at the bills that were passed last session both in the House and the Senate, kind of tear them apart and see what the pieces are,” Benson said last week. “This is something they supported so I think it’s really important to start there and really understand not only the parts of the bill but how it tried to address a lot of our concerns around cost and access.”

Mass-Care, a group pushing Medicare for all legislation in Massachusetts and nationally, has for years tried to build support for a state single payer bill. In late January, the organization released a list of 42 cosponsors of a House bill in Massachusetts, including several senators, and 19 Senate bill cosponsors, including several state reps. There are 160 House members and 40 Senate members.

Mass-Care on Wednesday ripped legislation sponsored by Rep. Kate Hogan, a division leader in DeLeo’s reshuffled leadership lineup, that calls for a new commission to study the methods, cost and feasibility of establishing a single payer health system in Massachusetts.

The commission would have to make its recommendations by June 30, 2020.

The groups said Hogan’s bill was weighted toward single payer opponents and those with financial interests, and lacked sufficient representation for direct care providers, low-income people, people with chronic illnesses or disabilities, and senior citizens.

Sen. Julian Cyr, speaking at a lobby day last month for single-payer health care bills, used a rubber band ball to illustrate what he called the current “layers and layers and layers of a tremendously complicated sick care system.”

“I would be the first to want to -- I don’t have a knife on me, I should have a knife on me -- to take this and chop it and split it in half and move to a single-payer system tomorrow,” Cyr said at the rally day. “But I think we need to be honest about how complicated the system we’ve created is, and provide a roadmap and pathway for us to really meaningfully look at how we would do this.”

According to Mass-Care, bills sponsored by Sen. Jamie Eldridge and Rep. Lindsay Sabadosa would replace employer and employee premium payments to private insurers with a tax on payroll -- 7.5 percent for employers and 2.5 percent for employees -- to finance the single-payer system.