| Gov. Charlie Baker, in a significant moment for the moderate Republican on the national stage, will testify Thursday before senators in Washington where, based on his written testimony, he plans to admonish the tenor of the debate over health care and urge a minimum two-year extension of premium cost sharing reduction payments worth millions of dollars to health insurers and residents in Massachusetts.
Baker has been called to testify before the Senate’s Health, Education, Labor and Pensions Committee alongside four other governors, including Democrats and Republicans from Montana, Tennessee, Utah and Colorado.
The hearing is part of an effort by the committee’s chairman, Sen. Lamar Alexander (R-TN) to stabilize health insurance markets under the Affordable Care Act on a bipartisan basis in the wake of the defeat of GOP repeal plans.
“The current debate in Washington about health care reform has destabilized the insurance market; carriers have responded by leaving some markets altogether or proposing to markedly increase rates to adjust for the uncertainty,” Baker wrote in written testimony submitted to the HELP committee ahead of Thursday’s hearing.
The six-page written statement, obtained by the News Service, lays out a handful of steps that the former Harvard Pilgrim Health Care CEO believes Congress should take to stabilize insurance markets and make health care more affordable for citizens. His comments in the documents are expected to go further than his verbal testimony before the committee on Thursday where he will offer a truncated version in his limited speaking time before fielding questions from the panel.
Baker opposed Republican plans to repeal and replace the ACA at every turn this year, objecting, among other reasons, to the potential loss of hundreds of millions of dollars in federal Medicaid support for Massachusetts.
Following the collapse of Republican-led efforts in Congress to repeal the ACA and reform the way states are reimbursed for Medicaid, President Donald Trump has, at times, threatened to end what are known as cost sharing reduction payments.
Those payments, which have also been challenged in court by the Republican-led Congress, are used by insurance companies to keep premiums down and are worth $123 million to Massachusetts insurers and residents in 2018.
Baker writes in his testimony that the month-to-month uncertainty around the CSR payments is working to undermine market stability, and he urges a guarantee for the payments of “at least two years.”
“I cannot stress enough how critical it is for federal cost sharing reduction payments to be resolved affirmatively in order to maintain market stability and to constrain rate increases,” Baker wrote.
Baker said the Congressional Budget Office believes ending the payments would be more expensive for the federal government because it would have to pay out more premium tax credit subsidies.
Baker also defended the ACA’s individual mandate to purchase insurance, which he described as a crucial linchpin in the 2006 universal health care law in Massachusetts because it ensured the presence of a healthy population in the marketplace that kept costs down for those who needed more expensive care.
“If people do not have to carry coverage when they are healthy, and can access it only when they get sick, break a leg, need to have a procedure, or something else, then the rest of us are unfairly tagged with paying for the cost of their care,” Baker said.
The hearing at the Capitol is scheduled to start at 9 a.m. on Thursday.
