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Compromise near on state health plan, senator says

Legislators are close to reaching a compromise on a healthcare plan for the uninsured, Senator Richard T. Moore said yesterday, adding that he expects to have a bill on Governor Mitt Romney's desk by mid-February.

Moore, the Senate's lead negotiator, said Romney's promise Wednesday to set aside $200 million for the plan would move negotiations forward.

But Moore's House counterpart, Representative Patricia A. Walrath, said the new money would not speed a resolution of House and Senate differences over how to fund a healthcare overhaul. And House Speaker Salvatore DiMasi said the money is ''not a substitute" for the employer tax that is a centerpiece of the House plan and a stumbling block in negotiations.

''It's a one-time revenue source and we need a sustainable revenue source in order to make this work," DiMasi said. ''I also believe that employers have to be part of the equation in some way."

DiMasi and Walrath declined to discuss the progress or timetable of the conference committee that is working on a health plan, citing the committee's confidentiality agreement.

The state is under pressure to devise a healthcare plan before July 1 or lose $385 million in federal matching funds. Federal officials had urged the state to finalize a plan by Jan. 15 to give federal officials time to review it. But a federal spokeswoman said yesterday that the January date was never a hard deadline. Later passage of a healthcare law might delay federal aid, but would not likely jeopardize it, said Mary Kahn, spokeswoman for the federal Centers for Medicare and Medicaid Services.

Both Walrath and Moore, the cochairs of the Legislature's Health Finance Committee, agreed yesterday that Romney's proposal was a major concession. Romney had previously insisted that the state could cover all 500,000 or more of the state's uninsured, using only the $1.3 billion currently spent on healthcare for the uninsured.

Yesterday, Romney's spokesman, Eric Fehrnstrom, said the governor is proposing a $200 million reserve for fiscal 2007 because ''revenue seems to be a sticking point in the conference committee deliberations. . . . With this $200 million, the governor is making a good-faith gesture to help move the discussion." The money will be included in the budget Romney is scheduled to unveil next Wednesday and would be drawn from general revenues, if needed, next year and in future years, Fehrnstrom said.

The House and Senate each passed health insurance plans last year that differ in many key aspects. The House plan relies on a payroll tax on companies that do not provide health insurance to their employees and also mandates that all individuals buy insurance. The Senate plan covers half as many people and requires large employers to pay health costs for any employees who tap the state's ''free-care" system. Both plans also would expand the state's Medicaid program.

House and Senate negotiators met yesterday and left the payroll tax on the table, despite continuing opposition from business leaders, the Senate and the governor, Moore said. The conferees are ''far more in agreement than disagreement on the issues," Moore said, ''but I don't think anything has been ruled out." However, he said, Romney's $200 million proposal ''helps to make the employer tax less important as a funding source."

''It's ultimately going to cost more than" the $200 million, Moore said.

The Massachusetts Taxpayers Foundation, a nonpartisan group that monitors state spending and opposes the payroll tax, estimated last month that covering the uninsured would require about $200 million more in state spending next year, $400 million more in 2008 and $600 million more in 2009, as long as some of the money was matched with federal dollars.

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