A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

"We should be just as concerned about our commitment to our values as we are about the value of our commitments"

"We should be just as concerned about our commitment to our values as we are about the value of our commitments"

October 29, 2009

Citing a new mantra - “Leadership Through Values” - Governor Patrick announced $352 million in cuts to the FY10 state budget this afternoon. He described how he balanced his constitutional duty with his moral values: “Those values include creating good jobs at good wages, offering a world-class education to our kids, delivering quality, affordable health care to our residents, protecting and supporting the most vulnerable – those are the values to which we as a Commonwealth are committed. So as I meet my statutory responsibility to bring the budget in line, I do so according to my moral responsibility to those values.”

The cuts announced today included a $3.5 million reduction in the MassHealth administrative line item; no cuts were made to eligibility or services. In this grim fiscal climate, we applaud the Governor for upholding his commitment to health reform by preserving MassHealth and Commonwealth Care eligibility and services. By preserving MassHealth adult dental benefits, for example, approximately one in ten Massachusetts residents will continue to have access to cost-effective preventive oral health care.

This is not to say that MassHealth is out of the woods for the remainder of FY10, because the agency is operating at a $300 million deficit. The possibility exists for further action in upcoming weeks and months to address the MassHealth shortfall.

In addition to the lack of MassHealth line item cuts, the accompanying legislation proposed a transfer of $30 million from the General Fund to the Medical Security Trust Fund, which pays for medical coverage under the Medical Security Program for unemployed workers. Currently, over 27,000 unemployed individuals and their families in Massachusetts depend on the MSP for affordable health coverage. This transfer will need to be matched with other funding, including adjusting the employer assessment, in order to enable the program to operate next year.

Despite this positive news, there were cuts to many important programs in the Department of Public Health, Department of Mental Health, and in the Executive Office of Elder Affairs. DPH took an $8 million hit and HCFA priorities including the Division of Health Care Quality and Improvement, the Pharmaceutical and Medical Device Marketing Regulation program, and Health Promotion and Disease Prevention were reduced. School-based health, teen pregnancy prevention, and smoking cessation programs were also cut while funding for the primary care workforce development program was eliminated entirely. DMH lost over $10 million in funding, mostly in adult mental health services.

Prescription Advantage was reduced by $5.6 million, likely signaling that premium assistance for low-income Prescription Advantage enrollees will be eliminated. This represents another 14% cut to their budget, after a 30% cut was imposed from FY09 to FY10. AARP noted that Prescription Advantage is a lifeline for thousands of seniors who are struggling to afford their medications. These cuts will surely lead to increases in other costs, as drugs keep seniors health and out of more expensive care.

Cuts will also deeply affect welfare and housing programs for low income people. Some 8,400 families with a disabled member will lose benefits, and 700 families' grants will be reduced. Homeless shelters will also face cuts. The Mass Budget and Policy Center quickly posted an overview of all the cuts.

Governor Patrick filed this adjusted budget with a request to the legislature to grant him authority to make cuts beyond his branch. Every state manager has been asked to take a 9-day furlough and agency heads have been told to make additional personnel cuts which accounts for $35 million. The Governor remained adamant about not cutting local aid because he feels that local towns and cities have been cut enough.
- Suzanne Curry and Jessica Hamilton