State Update
Swift Budget Seeks Additional Medicaid Funding but Would Cut Several Public Health Programs

Despite a sputtering economy and a phase-in of a new round of tax cuts, Gov. Jane Swift’s proposed budget for the next fiscal year included a substantial increase for the Medicaid program.

However, it remained unclear whether her proposed $578 million Medicaid increase would simply meet escalating program costs or whether some of that money might be earmarked to increase reimbursement to physicians or other health care providers.

Gov. Swift kicked off the process of crafting a new budget on Jan. 23. She sought to avoid a massive deficit by limiting most spending increases and offering cuts in a variety of programs. Health care was affected in both ways -- with the proposed Medicaid increase as well as a plan to scale back certain current health care and public health initiatives.

Lawmakers Will Revise
Of course, the final budget turned out by the legislature months from now is bound to differ greatly from the governor’s plan.

The MMS continues to press for Medicaid rate relief for physicians as its top legislative priority. The governor also recommended a 15 percent increase for the Prescription Advantage Program to help seniors afford pharmaceuticals. Her plan would raise that appropriation to $100 million. She also proposed increasing the Board of Registration in Medicine’s budget.

Health Care Cuts Sought
Not all health care programs fared as well. Some of the proposed cuts have already raised protests among health advocates. As part of her budget-balancing strategy, the governor would eliminate dental care for 500,000 Medicaid recipients and severely reduce the Department of Public Health’s successful Tobacco Control Program from $48 million to $19 million.

Her proposal would cut $11 million from the $17 million now allocated to prevention and detection programs for osteoporosis, multiple sclerosis, hepatitis C, renal disease, neurofibromatosis, and breast, prostate, and colorectal cancer.

First Stop, the House
The budget goes first to the House, where the Committee on Ways and Means is already crafting its own spending blueprint. Once House action is completed, the measure will go to the Senate. Senate and House differences must be reconciled in a Conference Committee compromise bill.

With the November elections, budget making will be complicated by the maneuverings of candidates for governor, and other statewide offices and legislators seeking reelection. The state’s fiscal year begins July 1. The current budget was not enacted until late November, but no such delay is anticipated this year as the legislature is scheduled to adjourn July 31.

- Steve Shestakofsky