One major goal of the Affordable Care Act is to slow the growth in health care spending without compromising on the quality of care. So far, it seems to have done that, bringing projected Medicare costs down by nearly $70 billion, according to the Congressional Budget Office. Now, spurred on by Gov. Deval Patrick (D-MA), the state that created the blueprint for Obamacare is following its lead.

Last night, the Massachusetts Senate passed a bill projected to trim $150 billion off state medical costs over 15 years. As the Boston Herald reported, health care spending currently consumes about 40 percent of the state budget and is expected to double by 2020. This legislation, passed by an overwhelming 35-2 vote, aims to reduce that burden by changing the way medical professionals care for patients and taking steps to keep Massachusetts residents healthier:

The bill, which was debated over two days in the Senate and required the consideration of 265 amendments, would seek to limit health care cost growth to a level at or slightly above overall state economic growth.

It aims to achieve that goal by encouraging hospitals and doctors to adopt new care delivery and payment models focused on patient outcomes rather than quantity of care provided, and would transition state-funded health care programs away from fee-for-service to alternative payment systems by 2014.

The Senate has also proposed to invest $100 million over the next five years in a transition to electronic medical records, and another $100 million in wellness and prevention programs paid for with an assessment on insurers.

Celebrating the vote, Senate President Therese Murray said Massachusetts “[o]nce again” leads the U.S. on health care. Moving medical records to an electronic format is expected to reduce administrative expenses, while prevention initiatives could cut health care costs by potentially billions of dollars, reducing the burden on taxpayers without negatively impacting care. A study released last year, meanwhile, found that doctors will improve the quality of care if their performance is tracked.

Leaders in the Massachusetts House have their own version of this bill that differs from the Senate version, including a luxury tax on some high-cost hospitals featured in the House version, which Murray said she would not support. An architect of the bill, Sen. Richard Moore (D), said he hoped “the bulk” of the bill would ultimately become law.

-Zachary Bernstein

Mitt Romney’s proposal to transform Medicaid into a block grant program could reduce access to health care for lower income Americans and jeopardize the health care reform he signed into law as governor of Massachusetts, the Boston Globe reports. “As governor, Romney worked closely with the late Democratic Senator Edward M. Kennedy to secure hundreds of millions per year in federal aid to realize their shared goal of access to health care for all. Expanding Medicaid coverage – and the flow of federal money that came with it – was a key underpinning of the state’s 2006 law”:

“It would have been impossible for Massachusetts to do what it did without increased federal Medicaid support,’’ said John McDonough, a major architect of the state’s health care overhaul law and now director of Harvard University’s Center for Public Health Leadership.

“What he’s proposing is in direct opposition to what he did as governor,’’ said Amy Whitcomb Slemmer, executive director of Health Care for All in Massachusetts, citing the Bay State’s 98 percent coverage rate, the highest in the nation. “That kind of expansion would not have been possible under a block grant program,’’ as Romney has proposed.

Indeed, Romney funded his 2006 health care expansion by re-appropriating state funds and relying on additional federal Medicaid funding he secured from the Bush administration. As Romney himself explained to Bill O’Reilly in April of 2010, “[F]rom the beginning the plan was a 50/50 deal between the federal government and the state government. The Feds fund half of it, they have from the very beginning.” The Boston Globe notes that “approximately 56 percent of the gain in coverage was related to increased federal Medicaid support” in Massachusetts, and of the newly insured, “18 percent gained coverage through Medicaid, and another 38 percent gained coverage through Commonwealth Care, a program that federal Medicaid dollars pay half of.”

As a presidential candidate, however, the former governor has argued that he could lower federal spending on Medicaid by transferring control of the program to the states and transforming the current matching-rate funding structure into block grants that would pay states pre-determined funding amounts. The “blocks” would not increase with health costs or automatically rise during economic downturns.

According to a Congressional Budget Office (CBO) analysis of Rep. Paul Ryan’s (R-WI) Medicaid block grant proposal — which is very similar to Romney’s — federal expenditures on the program would be “49 percent lower in 2030 than current projected federal spending.” “[T]he magnitude of the reduction in spending relative to such spending in the other scenarios means that states would need to increase their spending on these programs, make considerable cutbacks in them, or both,” the Office concluded. “Cutbacks might involve reduced eligibility for Medicaid and CHIP, coverage of fewer services, lower payments to providers, or increased costsharing by beneficiaries—all of which would reduce access to care.”

Democrats are accusing Sen. Scott Brown (R-MA) of hypocrisy after the Massachusetts Republican and staunch opponent of the Affordable Care Act revealed to the Boston Globe on Tuesday that he relies on a provision of the law to keep his 23-year-old daughter “on his congressional health insurance plan.” Brown ran as the 41st vote against President Obama’s health care reform bill in a special election to replace the late Sen. Ted Kennedy and voted three times to repeal the law.

But now, he’s brushing off the criticism by insisting that “he was actually taking advantage of the law in Massachusetts that allows children to remain on their parents’ insurance plan until age 24.” “You can do that in Massachusetts, I voted for that,” Brown said. “For (Warren) to call me a hypocrite as to how Gail and I provide for our family, it’s sad,” Brown said, referring to his wife, Gail Huff.

Brown may have taken advantage of Massachusetts reform while serving in the Bay State, but as a senator, he’s benefiting from the ACA’s most popular provision.

According to the Office of Personnel Management’s (OPM) website, Brown’s congressional health care plan (the Federal Employees Health Benefits Plan) is regulated by federal law, not state legislation — “The FEHB Program is a Federal program and preempts state law requirements,” the site says — and the program allows dependents to stay on their parents’ insurance plans until age 26 as a result of Obamacare:

An official at OPM confirmed to ThinkProgress that “As long as the parent has a self-and-family enrollment, dependent children are covered under that enrollment until they reach age 26, as a result of passage of the ACA. Before the ACA, the dependent age was by FEHB law up to age 22.”

The Brown campaign did not return multiple requests for comment.