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Today the National Rural Health Association has added its voice to oppose the special deal for Massachusetts – referred to by some as the “Bay State Boondoggle” – in the Patient Protection and Affordable Care Act.

Excerpt from the NRHA announcement:

“Today, the Coalition of America’s Hospitals announced that the National Rural Health Association (NRHA) has officially joined its efforts to reverse the adverse national impact of Section 3141 of the Affordable Care Act (ACA). ‘NRHA is pleased to join this important coalition fighting to end the manipulation of the wage index,’ explained Alan Morgan, CEO of NRHA. ‘Because, if no action is taken, hospitals around the nation could lose billions of dollars, and such a loss will have a disproportionate and potentially devastating impact on small, rural hospitals. It is an outrage that this blatant manipulation is allowed to continue.’" (emphasis added)

For more information, below is a summary highlighting Dr. Coburn’s questioning Secretary Sebelius on this special deal for Massachusetts in a recent Finance Committee Hearing.

Dr. Coburn Questions Sebelius on “Bay State Boondoggle”

Asks Why HHS Didn’t Warn Congress of ‘Manipulation’ Benefitting
Massachusetts, But Costing Other States a Total of $4 Billion?

On February 15, 2012, HHS Secretary Sebelius testified in the Senate Finance Committee about the President’s FY13 Budget. Dr. Coburn asked Secretary Sebelius about a provision of the Patient Protection and Affordable Care Act that benefits only hospitals in Massachusetts at the expense of hospitals in the 49 other states.

Last month, 19 state hospital associations voiced their opposition to this special deal for Massachusetts in a letter, saying member hospitals in 49 states will see their Medicare rates slashed by $3.5 billion over the next 10 years to pay for the this deal. The provision of law overrode Medicare's rules regarding its hospital wage index system, providing a financial windfall for Massachusetts hospitals

Today Dr. Coburn tried asked Secretary Sebelius why she did not try to fix the provision before it became law. The concern he raised was that the Administration had to be aware of this provision in the law prior to enactment, because HHS reviews and provides technical assistance on pending legislation before it’s passed. So the question is, why did HHS not express concern about this provision of PPACA when they later characterized this funneling of nearly $4 billion in Medicare payments away from other states to Massachusetts (in Federal Register comments) as a “manipulation” of the Medicare program?

Given the President’s focus on “fairness,” does HHS believe that funneling nearly $4 billion away from other states’ reimbursements from Medicare program to give to Massachusetts is a “fair” use of taxpayer dollars? Dr. Coburn explained that the states represented on the Finance Committee alone stand to lose more than $250 million from this Massachusetts deal.

Contrasted with a predictable support letter by the Massachusetts delegation for the special deal, some have called this the special deal for Massachusetts the "Bay State Boondoggle” and suggested it joins the list of infamous ObamaCare special deals that were used to grease the skids in passage of the controversial health care law. Clearly, one state benefitted from an adjustment that penalized 49 other states. But it is unclear why HHS did not warn Congress if they found the provision to be a “manipulation” of the wage index.