The “end of fee for service”: Health cost wars break out in in New England #hcr #mapoli #aca

More than a river divides Vermont and New Hampshire. In the state that lives by the motto, ” Live Free or Die,” regulators and politicians declined to set up a health insurance exchange mandated as part of the health reform law. From the June 22 Concord Monitor:

John Lynch signed into law a bill that prohibits New Hampshire from planning, creating or participating in a state health care exchange under the 2010 federal health care law. The Democratic governor did so with the support of the state Insurance Department and conservative Republicans dead set against the health care law passed under the Obama administration.

Opponent were predicting — at the time of this story — that the Supreme Court would rule against the individual mandate and the health law would “fall apart.” That didn’t happen and now the feds will come in and set up the exchange.

Next door in Vermont,  the Green Mountain Care Board is reviewing hospital budgets. From Vermont Public Radio:

The board has established a cap on spending increases of no more than 3.75 percent annually. But as a group, Vermont’s 14 hospitals are seeking increases of roughly 7 percent for the coming 12 month period. “We know there are some legitimate reasons that hospitals might need to grow higher than the 3.75 percent, most of those having to do with circumstances beyond their control,” said Anya Rader Wallack, the chairwoman of the Green Mountain Care Board.

The board may allow some increases above 3.75 percent, if the hospitals can prove that they are using the money to make investments that will lower costs in the long run.

But Wallack says the bottom line is that hospital spending needs to be kept under control: “We have a responsibility to hold down costs. So we’ll be looking at all of these requests with an eye toward how we can stay within that target, because we don’t think Vermonters can afford more than that.”

Welcome to your future Massachusetts.  Health care cost containment can get ugly. For reporting on the Massachusetts cost control law, go no further than the Globe’s special section. From today’s Bill signing story:

Six years after Governor Mitt Romney required every resident to obtain health insurance, Governor Deval Patrick signed a law that many consider the second phase of that groundbreaking experiment: trying to rein in the state’s health costs, which are among the highest in the nation.

The new law — which Patrick signed Monday at a State House ceremony packed with hospital executives, health care advocates, and lawmakers — seeks to keep health spending from growing faster than the state’s economy through 2017. For five years after that, the law aims to further slow spending, to half a percentage point below the growth of the economy.

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