State Budget Cuts are Bad Here, but....

There is a lot individual and institutional pain in the budget cuts this year and there is more to come. But so far, Governor Patrick and legislative leaders have largely spared the state's free and subsidized health coverage programs: MassHealth and Commonwealth Care. Some providers argue that cutting insurance makes more sense than cutting programs for people who are already sick. They may have a point, but the insurance programs have politics on their side. Leaders on Beacon Hill want to, and are under pressure to, continue the success of the state's health coverage law.

Support for the insurance coverage law here is even more striking when you look at what's happening as other state's cope with budget gaps. A "Families USA" report out late last month has this summary: half of the states have enacted or proposed Medicaid or CHIP (Children's Health Insurance Program) cuts in FY '09 and/or FY '10.

Here are a few examples:

- in California, Governor Arnold Schwarzenegger proposes to cut the income eligibility for that state's Medicaid program from 100% of poverty to 72%. The report estimates that 430,000 parents would lose coverage by 2011.

- in Oregon, Governor Ted Kulongoski has proposed to reduce the income eligibility level in that state's Medicaid plan for some senior citizens and people with disabilities from $1,991 a month to $1,300 a month.

Other states are cutting benefits:

Louisiana is reducing the number of prescriptions allowed adults on Medicaid and delaying the start of some home and community-based services.

Oregon is considering ending dental and vision services.

During Governor Patrick's budget briefing last week, Administration and Finance Secretary Leslie Kirwan stressed that Massachusetts has made similar cuts in the Medicaid program during prior economic declines but is not doing so this time. Many governors are hoping that a proposed increase in federal Medicaid funding will offset the need for some of these cuts, but many state funded programs will be screaming for their share of additional federal funds, if they arrive.

Martha Bebinger