Last Friday’s Globe had a letter to the editor from BI/Deaconess’ Dr. Richard Parker concluding: “… I am waiting for some straight talk on the numbers.” Reasonable question — wonder why the mainstream media has not added light to this. Healthy Blog puts out the numbers as we understand them (hope this prints out OK — forgive the mess if it occurs):
| Sources | FY07 | FY08 | FY09 |
| Federal Safey Net Revenue | 605.0 | 610.5 | 610.5 |
| Federal Medicaid Match | 184.6 | 242.1 | 299.6 |
| Hospital Assessment | 160.0 | 160.0 | 160.0 |
| Payor Assessment | 160.0 | 160.0 | 160.0 |
| Free Rider Surcharge | 50.0 | 40.0 | 25.0 |
| Fair Share Assessment | 45.0 | 36.0 | 22.5 |
| General Fund | 125.0 | 125.0 | 125.0 |
| Existing Obligations | |||
| MCO Supplemental Funding | 287.0 | 180.0 | 160.0 |
| Free Care Pool/Safety Net Fund | 610.0 | 500.0 | 320.0 |
| SubTotal | 897.0 | 680.0 | 480.0 |
| New Spending | |||
| Children to 300% | 18.2 | 27.4 | 37.4 |
| Restored MassHealth Benefits | 48.0 | 53.0 | 58.0 |
| Medicaid Rate Increase | 90.0 | 180.0 | 270.0 |
| Commonwealth Care Subsidies | 160.0 | 400.0 | 725.0 |
| Subtotal | 336.2 | 660.0 | 1090.4 |
| Total Spending | 1,233.2 | 1,340.0 | 1,570.4 |
| Three Year Balance | +116.4 | +33.2 | -167.9 |
Major question from Dr. Parker — how does the $295 employer assessment pay for this big health reform package. Answer — it doesn’t. It’s a small part of a large package and the major source of money each year is federal.
Bigger question — how does this hold up? Our sense — passes the laugh test, plausible and tight. Likely to turn out as planned? Not likely — prepare for surprises, pleasant and unpleasant. That’s life in this territory. What’s important now — strong commitment by House and Senate leaders to make it work — real political commitment to meet the promises outlined in the soon-to-be new law. Up to all of us to hold them to it.
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