At yesterday’s meeting, the Health Care Cabinet took a final vote on controversial recommendations to reform our state’s health system. The main concern that garnered the most disagreement and public input was a recommendation to place all Medicaid and state employees in a downside risk payment model within four years. While the measure still passed, the vote was close at 11 to 8. Three members changed their votes to oppose the measure – Frances Padilla of the Universal Health Care Foundation of Connecticut, Josh Wojick of the State Comptroller’s Office and Dr. William Handelman, former President of the CT State Medical Society. Rev. Bonita Grubbs also voted against the measure, as she was not able to attend the previous vote. They joined the four previous no votes on the recommendation from OPM, DSS, DPH and the CT Health Policy Project. The Cabinet’s vote in favor of downside risk on an aggressive timeline stands in contrast to comments submitted by CT’s Medicaid and Behavioral Health oversight councils and the overwhelming majority of public input received at the Cabinet’s public hearing which ran three to one against the proposal. A minority report opposing downside risk and other recommendations was added to the final draft. Other proposals also garnered significant opposition including a tie on whether to set targets for value-based purchasing contracts.