Hearings on the governor's proposal to revamp health care in the commonwealth began in the Statehouse on Tuesday.

The Berkshire delegation joins the rest of the Legislature in having some substantive questions about the proposed legislation.

"I think there are a great number of us that have significant doubts about sections of this bill," said state Rep. Tricia Farley-Bouvier, D-Pittsfield.

Gov. Charlie Baker has proposed balancing $350 million in spending in the fiscal year 2018 budget with a raft of new employer health care assessments and a slowdown in the growth of the commonwealth's MassHealth program.

Baker administration officials on Tuesday urged lawmakers to get on board with reforms to rein in costs at MassHealth, but the House is poised on Wednesday to create a showdown with the governor by sending him back a $200 million package of new employer assessments and unemployment insurance rate relief without the MassHealth changes, according to two senior House officials.

The budget Baker signed last week already chopped $350 million from the MassHealth program, Senate budget chief Karen Spilka said, adding that she wants to learn more about the impacts on low-income individuals of "sweeping" additional health insurance changes proposed by the governor.

As part of the commonwealth's landmark healthcare legislation passed in 2006, MassHealth provides the public access to free, subsidized, and full price insurance plans. The exchange also facilitates the delivery of Medicaid funded health care to low-income residents.

Farley-Bouvier sits on the Joint Committee on Health Care Financing, which held Tuesday's hearing. At the hearing, Health and Human Services Secretary Marylou Sudders said the administration's proposal to shift tens of thousands of residents from MassHealth into other subsidized plans would not cut people off from health care access.

"Our proposal before you today continues the strong commitment to affordable health care coverage in the commonwealth of Massachusetts," Sudders said. "I read somewhere recently that suggested we're actually cutting people off for access and eligibility. Nothing could be farther from the truth."

But opponents of the amendment say that the governor's proposals would have the practical effect of reducing the number of residents on the Medicaid program and instead direct some 140,000 members of the Massachusetts public to find private sector providers on the Health Connector.

That number is too high, said state Sen. Adam Hinds, D-Pittsfield.

"It's somewhat jarring to put forward a proposal that would move 140,000 off of MassHealth into higher out of pocket health plans," Hinds said.

Hinds added that he found the idea of cutting care in the current political climate at the federal level to be wrongheaded. The sentiment is shared by state Rep. Paul Mark, D-Peru.

"I think this is the wrong time for cuts to state level health care programs when we are facing so much uncertainty around health care at the federal level," said Mark.

It's not the governor's first attempt at revamping the health care system. Baker sought similar adjustments to the commonwealth's low income health access strategy in June. The changes were a last minute add-on to the budget and were introduced so late that there was no time for hearings.

"If we had implemented the governor's MassHealth reform, we would have been the first state to roll back Medicaid," said Farley-Bouvier. "That is stunning for Massachusetts."

The governor sent the bill back to the legislature in the form of an amendment. Such amendments are considered as a piece of legislation and are subject to hearings and votes as would be any law — though the budget amendments that return to the governor's desk may only be signed or vetoed, not amended further.

At least one member of the Berkshire delegation welcomed the opportunity to debate the governor's proposal, however. State Rep. William "Smitty" Pignatelli, D-Lenox, told The Eagle that the commonwealth needs to face the reality of declining tax revenues and an expanding program. That may mean hard choices, said Pignatelli, but they're choices that need to be made.

"I don't see an outcry to raise taxes, but that's where the money comes from," said Pignatelli. "I think we should really roll up our sleeves and find out how to pay for it and preserve it."

Reach staff writer Eoin Higgins at 413-464-4872 or @BE_EoinHiggins. Matt Murphy and Katie Lannan of State House News Service contributed to this report.