In letter, Charlie Baker urges Congress to save key element of health care law

Jan. 12--Gov. Charlie Baker is urging the Republican-led Congress to allow Massachusetts to keep its mandate that residents have health care without saddling it with additional costs, offering the first signal of how the Republican governor intends to grapple with moves on Capitol Hill to dismantle Obamacare.

Baker, writing in a letter to Rep. Kevin McCarthy, the majority leader, extols many of the benefits of the Affordable Care Act, pointing to protections for residents such as ban on exclusions around pre-existing conditions.

The letter's measured tone positions the moderate Republican far from the rhetoric in Washington, where President-elect Donald Trump is pushing to ax President Obama's landmark health care law. In an overnight vote, the U.S. Senate took a first significant step earlier today toward repealing Obamacare, though details around vows to replace it remain scant.

"Massachusetts seeks flexibility to achieve the goals inherent to the Affordable Care Act and Medicaid programs while meeting the needs of the state," Baker wrote in the letter, which came in response to McCarthy's request for input from the country's governors.

"As an overarching statement," Baker wrote at another point, "Massachusetts believes strongly in health care coverage for its residents."

Baker notes that more than 96 percent of Bay State residents are insured. And though the state's initial implementation of its first-of-its-kind health care mandate was "deeply flawed," he said that more than 220,000 people have insurance through the state's health care exchange and another 300,000 have insurance through Obamacare.

He urged McCarthy that as Republicans address health care, "it is important that coverage gains, patient protections and market stability are maintained."

Baker, a former health care executive himself, also said states should keep the flexibility to tailor health care to meet their own needs and demands.

Baker's push, however, also notes needs for reforms, though he never suggests anything as drastic as what Washington Republican leaders have vowed.

He said the addition of the federal health care law has pushed half of a million people from private to public insurance, helping balloon the state's budget, 40 percent of which is devoted to Medicaid costs. All the while, Baker notes, the number of those uninsured -- about 3 percent -- has remained level.

But any changes should come on a "gradual timeline," Baker wrote, and any move to give states more flexibility shouldn't also mean a significant shift in the cost.

"We are very concerned that a shift to block grants or per capita caps for Medicaid would remove flexibility from the states as the result of reduced federal funding," he said, noting Massachusetts splits costs 50-50 with the federal government. "Any Medicaid reform should start with the assumption that every state's current federal share establishes the baseline."

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