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House Budget Plan Includes Nearly $2B Of Cuts, Savings

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House budget leaders say they are spreading the pain in the $30 billion budget released Wednesday. There are cuts and savings of $1.9 billion, many in line with the spending plan Gov. Deval Patrick released in January. There are no new taxes or "gimmicks," according to House Ways and Means Committee Chairman Brian Dempsey, and the House will not be considering gambling or other forms of new revenue when budget debate begins in two weeks.

WBUR's Martha Bebinger joined Morning Edition Thursday with more details on the spending plan.


Bob Oakes: There are cuts across the board, including $32 million from the Department of Public Health. State universities will get $60 million less than last year. What are some of the biggest items?

Martha Bebinger: One of the biggest items in the budget is Medicaid. The House has adopted the governor's plan to trim spending by $800 million. A lot of that is in trying to spend more efficiently.

Massachusetts, unlike some other states, isn't freezing enrollment or capping benefits, for which advocates are grateful. But Health Care for All Director Amy Whitcomb Slemmer said proposed cuts in dental care for low-income adults, early intervention services for children and the elimination of a coverage for legal immigrants must be reconsidered:

This becomes a cost shifting issue, where our hospitals and providers are going to have to make up for this uncompensated care. We truly see this as a dramatic step backwards in the gains we've made in health care reform.

Hospitals are again, not in line for a promised rate increase. $2 million in HIV/AIDS prevention and treatment will be cut, which AIDS Action said will cost the state in new cases and disease treatment.

The Women, Infants and Children food assistance program, also known as WIC, would lose 20 percent of funding. Home care and day care services for senior citizens will get less than last year.

There are cuts in recycling, environmental protection and parks funding.

The House agreed with Patrick in many ways on where to cut, but there are a few exceptions. The House would not close two prisons to save money and rejected his idea of creating a new department for public defenders. Why?

No, the House said the details of that plan were vague. They will instead look for savings in food and health services. With the public defenders, the House said for now, the state could save $53 million by capping the number of hours that private attorneys can work, among other things.

This proposed budget does not fund the governor's plan to merge the state probation and parole agencies under the executive branch and trims money from programs the governor is pressing to close the achievement gap.

One of the most controversial parts of the House budget is an outside section that would let cities and towns change what's in a health insurance plan, the co-pays and deductibles, without any say from unions. Budget leaders say this will save $100 million next year, but unions are mounting a fight. Where's this headed?

It's expected to pass the House. The leaders who wanted to get it past strong union backers put in the budget where to vote against it — a representative has to vote against the budget, which many don't like to do.

In the Senate, Senate President Therese Murray said she's working on an alternative plan, one that would continue to give unions a say in how much they pay out of pocket for health care. Patrick also wants unions at the table in talks about lowering municipal health costs, said his Secretary for Administration and Finance, Jay Gonzalez:

These are benefits that they...impact these employees...and he's been clear that they can't veto getting to the result, they should be a participant in the process for how to get there.

Many business groups and the municipal foundations support the House plan, they say it's the only way to bring municipal health costs more in line with what state and private sector employees pay.

This health care change is supposed to offset a $65 million cut in direct aid.

State money for local schools is up 3.1 percent in this budget.

The House proposes using $200 million from the state's rainy day fund and not adding the $100 million that the state is supposed to, by law, add next year. How much is left and what's the thinking about how many more tough budget years are to come?

Almost $600 million left, that's down from more than $2 billion three and a half years ago. This proposed budget is one of, if not the biggest, cut in state spending from one year to the next in close to two decades.

The economy is rebounding, but slowly, and federal stimulus funds are gone. There's a lot of concern looking ahead about the federal budget debate and how rolling back programs such as Medicare and Medicaid would hurt the health care sector in Massachusetts. Many Republicans say it's time for Massachusetts to get used to operating with less money and exercising more fiscal restraint. There are some on the left who hope the Legislature will consider the House's no new revenues pledge, but we're not seeing that yet.

More:

This program aired on April 14, 2011.

Headshot of Martha Bebinger

Martha Bebinger Reporter
Martha Bebinger covers health care and other general assignments for WBUR.

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