Today the House and Senate sent to the Governor the FY 2014 budget (giant pdf), which was filed by the joint conference committee late last night.
But we were smiling when we turned first to the Medicaid line items. Smiling, of course, because the final budget includes $17.2 million to restore coverage for dental fillings for adults in the MassHealth program. These funds should allow the MassHealth dental benefit to include fillings beginning the first of the year.
We will continue to work for full restoration of all dental benefits. But this is another step towards recognizing that oral health is integral to overall health, and an effective MassHealth program must cover good dental care.
The budget also included funding for the academic detailing program, which provides objective information to physicians and other prescribers about the effective use of prescription drugs, as opposed to the biased sales pitches doctors hear from drug marketers.
We need to look closer at the Medicaid and health reform line items, but we were pleased that the conferees went a bit higher than the House/Senate split-the-difference funding level for the MassHealth operations line item, which is critical for meeting the needs of MassHealth members, and for the costs to implement the ACA. We were very concerned, however, to see that the budget set a funding level for medical care for people newly eligible under the ACA that was lower than either the House or Senate figure. This will probably mean that several MassHealth initiatives intended to reduce gaps in coverage and assure broad coverage as part of the ACA will not be funded.
We also have not looked closely enough at the DPH line items, but it appears in many cases that the budget tries to nudge up DPH funding for many vital services. (UPDATE: more details are available at the Mass Public Health Association blog post, FY14 Conference Budget Includes Victories for Public Health.) We were dismayed at the cut in tobacco control funding, and echo MPHA’s comments:
Smoking Prevention and Cessation Services are cut by $180,000 from FY13, or about 5% of funding. After years of dramatic cuts to tobacco funding and in a year when a hike in the cigarette tax promises to bring in millions more in tobacco revenue, this cut is particularly troubling.
The budget is another step in moving away from our chapter 58 statutory structure to the ACA. The Commonwealth Care program is funded for just 6 months, as the program ends on January 1. One important milestone in the budget is the repeal of the employer fair share requirement, effective today. Because the federal ACA employer requirements do not start until January, this leaves a 6-month window with no mandate on employers to provide health insurance. Given the continued strong support by employers of health coverage in Massachusetts, we do not expect any real drop in coverage rates. We will closely monitor our helpline callers, which will let us detect any abrupt changes in employer coverage.