How much more is health reform going to cost the state next year?

The answer is $156 million, not $400 million (details below). If you follow MA health reform, there are a lot of reasons you might think $400 million is the bad news number.

A glance at the Globe’s top story last Thursday might make you think it’s $400 million. The lead: “Spending on the state’s landmark health initiative would rise by more than $400 million next year, representing one of the largest increases in the $28.2 billion state budget…”

In Bob Kuttner’s Globe column Monday, the $400 million gets worse: “the Globe recently disclosed [that] the program’s costs are outstripping its projections by … $400 million next year.” Similarly, yesterday’s Wall Street Journal op-ed by Shikha Dalmia (no link), states that “The state health-care bill for fiscal 2008-2009 is expected to touch $400 million — 85% more than originally projected.” Today, CNN’s respected Dr. Sanjay Gupta reported that “While more people than ever are covered in Massachusetts, the cost overruns have been more than $400 million.”

So now, $400 million isn’t just the amount of spending growth, it’s being called all unanticipated growth and cost overruns. The story has falsely morphed to mean that health reform spending will be $400 million above projections — that state officials had predicted no growth next year. This in a program that is still ramping up enrollment and subject to medical inflation like everything else. Substantial spending growth has always been anticipated. It’s not all cost overruns.

$400 million isn’t even the relevant number.

Yes, health reform spending in the governor’s budget is projected to increase by $402 million next year. But Medicaid is a matching program – more spending means more federal help. The revenue expected for next year should go up by $246 million.

This leaves a much more manageable $156 million increase that must be filled from state resources.

So the “$400 million” isn’t all unanticipated and isn’t all coming from state taxpayers.

Once bad data gets out, it’s almost impossible to recall. The enemies of chapter 58 are all over this. A $400 million cost overrun has been reported in papers all over (like Utah), in Republican blogs, in influential California health news digests, press releases and more.

How do you get back all the feathers, once the pillow has been burst?
Brian Rosman