The Massachusetts House Tuesday night overwhelmingly approved its 278-page plan to curb the soaring cost of medical care. The final vote—148 to 7—sets up what could be difficult negotiations between the House and the Senate, which approved its own cost-control legislation last month.
The House debated hundreds of amendments but did not make significant changes to its bill, although it did adopt a $20-million tax on hospitals and insurers that would fund prevention and public health programs.
In a written statement from House Speaker Robert DeLeo summarizing the bill, House leaders laid out high hopes for what the proposal could achieve for consumers.
“Massachusetts has the best health care system in the nation, but we also lead in medical spending,” said Steven Walsh, a Democrat from Lynn who oversaw the House effort. “Health insurance premiums for a family average over $15,000 annually and mean lower wages, and less money for mortgages, rent, car payments, food, and tuition. This legislation focuses on increasing efficiency, eliminating waste, and curbing costs, all while enhancing the quality of care that our patients receive. We will not only save money for Massachusetts citizens, but we will save our health care system over $160 billion in the next fifteen years.”
The House and Senate plans contain key differences - particularly over how much the health care industry can be relied on to control costs on its own—that will be debated intensely in the coming two months. The Senate bill generally allows doctors and hospitals more leeway to find their own solutions, while the House wants more oversight.
Both plans require the health care industry to reduce the growth in spending. By 2016, the House calls for spending to shrink to half a percentage point less than the rate of growth of the average gross state product, a measure of economic activity. The Senate believes the industry should not be forced to grow more slowly than the economy overall.
The Senate also takes a softer approach to regulating high-priced providers including some of the major academic medical centers. The House is proposing a luxury tax on providers that charge prices deemed excessive and that they cannot prove are linked to above-average quality or unique services. That money would be redistributed to financially shaky hospitals.
The House and Senate also will have to negotiate with Governor Deval Patrick, who said Monday that he would like the final bill to address how hospitals with strong market share drive costs. While he is unconvinced that the luxury tax is the way to do that, Patrick said “enhancing” the power of Attorney General Martha Coakley to address anti-trust activity may be necessary. He didn’t provide details.
“There’s a sentiment among some that she ought to have more power or ought to have more than one gear, and if that’s what it takes for the full framework for anti-trust enforcement to be effective, then we should have that,” Patrick said Monday afternoon.
(Globe reporter Michael Levenson contributed to this entry.)