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"Put Patients First!" by Celia Wcislo

The recently signed American Recovery and Reinvestment Act will deliver necessary relief from a dismal financial situation in Massachusetts. And it can be used to restore some on the massive cuts made to health care this year, and in next year’s budget.

The Administration’s FY 2010 budget tried to protect eligibility and benefits for low-income residents. They proposed some expansion of Medicaid and CommCare with the assumption that more residents will be in economic trouble this year.

Unfortunately, they also made dramatic cuts in payments to hospitals that serve the poor, freezing rates for most other healthcare institutions and nursing homes, and cutting public health and behavioral health programs.

The rest of FY 09’s health budget was balanced by using $533M (for three quarters) of financial assistance from the Recovery Act. This week, Massachusetts will be eligible for $594M for just two of the three FY09 quarters.

In fact, the amount Massachusetts will receive before July 2009 is closer to $900M. This could mean some restoration of the $330M in Medicaid 9C cuts that have already been made.

For next year, the Administration’s budget anticipated using $711M from the Recovery Act. Yet most assessments of the bill have indicated that Massachusetts will receive twice as much – closer to $1.4 billion in increased Medicaid funds. This money could, and should be used to do the following:

· Increase rates of Medicaid payments to the two largest providers of care to the poor, Boston Medical Center and Cambridge Health Alliance. Ensuring residents have access to care requires paying the true cost of that care.

· Keep some money available to provide health insurance coverage for more people in case the recession grows worse.

· Restore many of the public health programs cut this year and in next year’s budget.

· Provide more rate relief to nursing homes, to at least make up for the $75M more in taxes they will be asked to pay in 2010.

· To honor Chapter 58’s commitment that Medicaid should pay better and closer to the true cost of caring for the poor, restore some rate relief to hospitals that treat Medicaid patients. Also, restore the cuts to Graduate Medical Education to primary care teaching programs.

· Restore the 2010 cuts to outreach and enrollment grants for groups helping people find health coverage.

The Recovery Act and Medicaid relief was meant to provide protection to state programs that help residents. Our Governor has attempted to honor the commitment to health care reform by keeping most programs intact. However, by cutting back on payments to hospitals, nursing homes, and health care centers for that same care, the Administration's currently policy takes one step forward and one step back. The good news is there is an opportunity to change that now. With Federal relief in sight, the Governor and legislature should restore cuts to our health care system immediately, particularly the cuts to patient services at Boston Medical Center and Cambridge Health Alliance. It is those cuts that currently pose the largest threat to the integrity of health care reform and require the most urgent attention.

Celia Wcislo is a board member of the Massachusetts Connector Authority, Assistant Division Director for 1199SEIU United Healthcare Workers East, and an Executive Board member of the Service Employees International Union.

This program aired on February 24, 2009. The audio for this program is not available.

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

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