Two separate State House rallies today made the case against further health cuts. And now an analysis of the proposed federal economic recovery package shows that Massachusetts should be receiving sufficient federal health funds to stave off further cuts -- and possibly reverse current cuts.
The first rally was sponsored by United We Stand For Public Health, a reborn coalition to protect our invaluable public health system. Several hundred people gathered in Nurses Hall to hear how public health cuts hurt - and how the strength of our community depends on public health. Later, the "Put Patients First" coalition delivered more than 5,000 postcards and letters to the governor, demanding the restoration of cuts to key safety net hospitals Boston Medical Center and Cambridge Health Alliance. HCFA participated in both events.
Here's NECN's coverage:
Today, the expert Center on Budget and Policy Priorities released their analysis (pdf, too) of the estimated new revenue Massachusetts and other states would receive under the proposed federal economic recovery package. The bill moved swiftly through the House committee process today, with full House approval expected next week. The Senate version has not been released, but action is due soon there as well.
The bill includes an $88 billion increase in Medicaid funds to states, through a temporary increase in the matching rate, for 2 1/4 years. Massachusetts currently gets a 50% matching rate (called FMAP), meaning the federal government reimburses the Commonwealth 50 cents for every dollar we spend on Medicaid. Under the House proposal, the rate would increase to at least 54.9%, and would go higher if we have a large increase in unemployment.
In addition to the health funds, the bill also proposes multi-billion dollar investments in specific state programs for education, infrastructure, human services, and $79 billion in general assistance to be divided between education and general state needs (apparently, Massachusetts doesn't subscribe to the service which publishes estimated state-by-state allocations of other funding, so we can't present a total for the other funds.)
The FMAP increase translates into lots of federal revenue:
FY 2009: $554,879,000
FY 2010: $1,361,344,000
FY 2011: $720,329,000
Total for 3 years: $2,636,552,000
To put the numbers in context, the Medicaid 9C cuts of last October was around $300 million. The Department of Public Health cut was $28.3 million, one of the highest percentage cuts of any EOHHS agency and among the highest percentage cuts for any area of state government.
Two key points:
First, although the final amounts may be higher or lower, the range will be close to the above numbers. With substantial help on the way, it is critical that state officials hold off on any more health cuts so that the new funds can be taken into account. Cuts to safety net programs and providers will result in the closing of facilities, the reduction of capacity, and the laying off of employees. The actions are difficult and time-consuming to reverse. Meanwhile, long-term health suffers, and we all will pay the cost. The administration should not put health programs through the painful cuts process when it is clear that funds will soon be available to allow the state to avoid much of the cuts.
Second, we must insist that the FMAP funds be reinvested into the health care system. To scoop these health funds for other purposes would violate Congressional intent, break precedent, and show bad faith. The Congressional intent cannot be more clear: "The bill would provide, on a temporary basis, additional federal matching funds to help states maintain their Medicaid programs in the face of recession-driven revenue declines and caseload increases." During the 2003 recession, funds from a similar FMAP increase were segregated in its own fund, and used to restore health budget cuts. Massachusetts will be getting lots of other new federal revenues designated for other purposes. Health money must be used for health.
The health community already agreed to major increases in premiums paid by low-income CommCare recipients, to increased assessments on insurers, employers and hospitals, and we spearheaded a $175 million cigarette tax increase. There is growing support for additional revenue dedicated to health, and broad revenue measures. With the federal funds likely to be approved, by mid-February, we urge the administration to delay implementing any addition cuts to health programs.