House Releases Budget Draft

The House Ways and Means Committee released its FY2011 budget recommendations today, the second time around for Chairman Murphy. The House proposal overall makes much deeper cuts than Governor Patrick’s proposal, mostly because it does not include any of the revenue proposals forwarded by the Governor.

As always, the instant analysis from the Mass Budget and Policy Center provides a solid overview and drill down into the whole budget proposal.

As promised, the HWM budget does not include any new revenue proposals. HCFA is advocating (along with the growing One Massachusetts Campaign) for a broad revenue package to close loopholes and cap ineffective tax breaks, including the removal of the tax exemption on non-nutritional candy and sweetened beverages, which was included in Governor Patrick’s proposal. HCFA is also advocating for the closing of a loophole that exempted cigars, smoking tobacco and smokeless tobacco from the 2008 cigarette tax increase.

What follows are some highlights of specific issue relevant to HCFA’s legislative coalitions and work on health access:

The HWM budget continues the commitment to Massachusetts health reform, which celebrated its 4th anniversary earlier this week. No new cuts are proposed to Commonwealth Care, which is allocated $838 million, projecting a slight increase in enrollment next year. The budget allocates $9.75 billion for Medicaid. The figure is a $601M increase to fund an estimated 3% increase in enrollment. The proposal also recognizes the ongoing need for a community role in enrollment and outreach and assumes a $2.5 million contribution for MassHealth outreach and enrollment grants to be funded through the Connector.

Children: Programs related to children’s health coverage matched the Governor’s proposals for the most part, including CMSP and Healthy Start. Early Education Mental Health Consultative Services was cut to $500K. The Governor had proposed an increase over the FY10 amount. The Children Behavior Health Initiative line item was also less than proposed by the Governor.

Legal Immigrant Coverage: The HWM budget recommends funding the Commonwealth Care Bridge program, the reduced-benefit plan for legal immigrants, at $60 million. The plan caps the program at its current enrollment, locking out some 13,000 eligible residents. The Governor had proposed a $75 million budget for the program, allowing for some growth.

MassHealth Adult Dental Care: The House language in section 32 permits EOHHS to determine what dental services are covered for adults in MassHealth and Commonwealth Care. The Governor had proposed saving some funds by restructuring adult dental benefits to cover preventive and emergency care, excluding restorative services. These would be available at Community Health Centers through the Health Safety Net program, though the CHC dental system does not have the capacity to absorb all of the demand for services. This cut will have serious long-term impacts, including increased costly emergency room visits, job loss, and poor overall health for Massachusetts.

Prescription Drugs: Prescription Advantage, the prescription assistance program for low-income elderly and some disabled individuals had a slight increase in its budget. While we are pleased that it received the additional funds, it falls far short of the needed funds to restore premium assistance for the low-income elderly. The House budget eliminates all funding for the state-sponsored evidence-based outreach and education program (often referred to as “Academic Detailing”). This program provides health care providers with balanced information about the effectiveness, safety and costs of all prescription drugs on which they can base their prescribing decisions.

Public Health and Health Care Quality: The Bureau of Health Care Quality within the Department of Public Health has faced tremendous cuts over the past few years. The bureau is crucial in the monitoring and implementation of Chapter 305, the quality and cost law from 2008. Decreased funding will lead to less oversight of the care consumers receive in health care settings. Protecting patient safety and reducing medical errors and infections is a commitment the state and the legislature made in 2008 and now is not the time to back away. Other DPH cuts include further cuts to Environmental Health, which affects food inspections, radiation monitoring and control, and investigations of environmental-induced illness. Also, modest cuts to Disease Prevention/Health Promotion and Smoking Cessation continue their downward trend as these programs have taken huge hits over the past years.

Tune back to the blog on Friday to see the budget amendments supported by HCFA to improve the health provisions in the budget. Amendments are due to the House Clerk by 5PM on Friday. House budget debate begins on Monday, April 26th.
-Mehreen Butt

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