Romney Budget Plan Would Cut Health Programs Again

The Romney administration began the state budget debate for fiscal 2005 by recommending more cuts in the health sector.

Eying a recovering economy, the governor's cuts were not as drastic as in the past, but they were still devastating to some specialized constituencies. The MassHealth budget was increased by about $500 million, which amounts to less than "level funding" because of medical inflation. The governor said that MassHealth eligibility levels would be unchanged, although enrollment in certain programs remained "capped."

Democratic leaders maintain there is a $500 million revenue shortfall, but it's unclear how this will be addressed. The Department of Public Health (DPH) did not fare as well, with programs such as school health services, prostate cancer education, and gambling addiction eliminated; AIDS prevention and treatment, substance abuse, and teen pregnancy programs reduced.

A ray of good news: the budget proposed that all revenues received by the Board of Registration in Medicine be exclusively used to fund that agency -- a long-time priority of the MMS.

MMS President Thomas E. Sullivan, M.D., said of the budget proposal, "We recognize the state is in fiscal straits, but the fact remains that health care is still underfunded in Massachusetts. The governor's proposed budget perpetuates a situation that has been existing for years. It is the height of irony that in a state with a reputation for some of the world's best health care, we continue to fall short in health care funding."

Dr. Sullivan added, "The combination of declining reimbursements and rising liability premiums has been a cause of particular concern in the physician community for the last several years, and the viability of physician practices throughout the state is in jeopardy."

Perhaps it's not surprising that state budget cuts of the last few years have reduced health care access and disproportionately cut public health programs. After all, Medicaid is a major budget item, and many public health prevention efforts seem to lack immediacy to the untutored eye. Nonetheless, the long-term effects of the cuts have been devastating -- resulting in increased, and costly, use of emergency services and free care, as well as the decimation of public health initiatives that had accomplished so much in areas such as tobacco control, teen pregnancy prevention and cancer screenings.

Since October 2001, more than 50,000 people have lost Medicaid eligibility, while applicants to the Uncompensated Care Pool have risen 128 percent. Over the past three years, the DPH budget had been slashed by 27 percent -- a cut disproportionate to other state agencies. This year's proposal would add another 8 percent cut to that figure.

The governor's proposal is but the first step in the lengthy state budget process. The House and Senate Ways and Means Committees will be crafting responses, and legislative leaders hope to bring a consensus budget proposal to the governor by June. The MMS will be actively engaged in all aspects of the budget debate. The Legislature is to conclude its "formal sessions" by July 31, but non-controversial measures will be considered at "informal" sessions through the end on the year.

- Steve Shestakofsky