Welcome, Governor Baker!
December 22, 2014 § Leave a comment
By Melissa Shannon, Director of Government Relations and Public Affairs, Commonwealth Care Alliance
As the Director of Government Relations at Commonwealth Care Alliance (CCA), I have been asked many times in the last few weeks what the election of Charlie Baker as Massachusetts governor will mean for CCA, our members, and our work to transform health care. Sometimes I can see worry on the faces of the people asking these questions. They might be thinking that Baker will call for changes to our robust Medicaid and social service programs. Or maybe they are thinking, “Who could be better for us and our members than Governor Patrick has been?” (A reasonable question; check Dually Noted soon for a retrospective of eight years of health care advances in the Patrick Administration.)
But, fear not, my friends. We have every reason to be optimistic about the incoming administration. Governor-elect Baker was not only Secretary of Administration and Finance (the budget agency) under Governor Weld, but also the Secretary of Health and Human Services from 1992 to 1994. He gets Medicaid inside and out, and he believes in it. What’s more is he gets that the health care system needs to work differently for those who rely on it most. Here is what he had to say at a February 2014 forum on health care reform, as reported by the State House News Service:
Baker said the current “transactional model” works well for 95 percent of the population that consume 50 percent of services, but are relatively healthy and only interact with the system once and awhile. For the remaining 5 percent that may have multiple illnesses and mental or behavioral health needs, he said those patients “pinball all over the system” because it isn’t well organized. To address this discrepancy, Baker said the state should be “a little less rule driven” and more interested in “creative non-compliance” by providers with good ideas to serve vulnerable citizens.
This is the political and organizational equivalent of “he gets me.” What could be better for us to hear from an incoming governor? And, just when those worriers might have been thinking, “But he won’t be directly overseeing health care, who will be doing that?” he appointed Marylou Sudders as his Secretary of Health and Human Services, the cabinet member overseeing MassHealth and all social service agencies.
No stranger to state government herself, Sudders served as Commissioner of Mental Health from February 1996 to February 2003. Marylou Sudders is one of the most vocal and effective advocates for comprehensive services for people with mental illness that Massachusetts has ever seen. Here is what she said at a Health Policy Commission hearing in October, in response to data showing that commercial insurers devote significantly less resources per person to mental health care than MassHealth does:
I will not be nice. I will look at this chart and say commercial players are not providing the services they need to provide where they need to provide it and at the rates they need to provide it … It is time for the providers and the payers to really step up and level that, so that $93 [difference in per member per month expenditures] is not sticking out like a sore thumb.
And, she knows the solutions are not quick or easy and will require an investment of resources. (See a letter to the editor she penned last August in response to a report on the state’s mental health system.)
We do have a lot to worry about in our interactions with government over the next four years. What will become of the One Care program after the three-year demonstration period ends? Will the rates in both One Care and Senior Care Options be sufficient to meet the need for services? Will the eligibility rules expand to allow us to serve all those who need our model of care and financially qualify for our programs? But, we can feel comfortable that we will be having these conversations with people who understand these questions completely and are as interested as we are in transforming the health care system for those who need it most. At the advent of a new administration, we could not ask for a better outlook.