HEALTH ACCESS UPDATE
Wednesday, June 11, 2003
CONFERENCE COMMITTEE (IN)ACTIONS
Attached is the shortened version of the Health Care Budget Cuts Scorecard. Below is a report from Beth Capell, Health Access legislative advocate:
Last (Tuesday) night, the Budget Conference Committee recessed until further notice. Conference committee chair Jenny Oropeza stated that the conference committee had done what it could do pending further decisions by the Big Five on both the larger budget framework and a variety of other issues, including trauma care funding. A handful of health issues were left open, including transitional Medi-Cal and trauma care funding. Most of the major health issues were not technically in conference because both the Senate and Assembly versions of the budget had restored proposed cuts to eligiblity, provider rates and other changes.
Earlier in the day, the conference committee took action on several utilization control mechanisms for various optional Medi-Cal benefits, such as durable medical equipment and laboratory services.
On Sunday, a document surfaced titled “Governor’s Proposal: Federal Temporary State Fiscal Relief Legislation” that would have allocated the new federal funding, expending the entire amount in the budget year and using almost all of it to restore Medi-Cal cuts along with several hundred million to fund the SSI/SSP COLA. This document was repudiated by Director of Finance Steve Peace who stated that it was not an Administration proposal but just staff work done by the Department of Finance to assist the conferees. This assertion was accepted by the conferees as helpful to resolving the health budget items, though it was received with some skepticism by the assembled advocates and staff who held in their hands a document that said, repeatedly, “the Administration proposes…”.
Since it could be indicative of the Administration’s thinking, one or two key points from this document: first, it suggests that the Administration believes that the cut booked by the Legislature from SB26x, done in April, for county performance standards, semi-annual status reports, and restrictions on adult dental services, may not achieve the savings that were anticipated. This may lead to an effort to re-open this issue in order to achieve those savings. Second, the document states an intent to restore virtually all of the proposed cuts, if it is possible to settle the larger budget deal in a timely manner.
The outlines of a larger budget deal remain uncertain at best. The increasing agitation of investment bankers who have loaned money to the State combined with the intransigence of Republicans regarding adequate revenues to repay those loans and the steady refusal of Democrats to cut health, education or other vital services and the genuine reluctance of many Republicans to defund these services are a volatile combination. Assembly Republican conferee John Campbell in his closing remarks noted with some bitterness that in the week the conference committee had been convened, they had gone backwards in terms of reaching agreement on the budget. In response, Ms. Oropeza noted that the Democrats were committed to revenues as part of a balanced solution.
It is possible to resolve this budget by rolling forward a significant share of the deficit: but most versions of that require some revenues in addition to the VLF (vehicle license fee). The more deficit that is rolled forward, the more health care is in danger of facing similar cuts in the next budget cycle. Barring an economic boom that no one anticipates, the conversation will once again be about the magnitude and nature of proposed cuts, not what we should be doing to assure that every Californian has the health care they need when they need it.