HEALTH ACCESS ALERT

Monday, March 8th, 2004

BUDGET BLUES

* California Senate Budget Subcommittee Considers Various Health Cuts

* U.S. Senate to Consider Budget Resolution With Health Cuts

SENATE BUDGET SUBCOMMITTEE HEARS HEALTH CUTS, REJECTS ENROLLMENT CAPS

The Senate Budget Subcommittee #3 on Health and Human Services, chaired by

Senator Wes Chesbro, met this afternoon for over four hours considering a

range of cuts proposed by Governor Arnold Schwarzenegger. Dozens of

advocates, organization representatives, and people directly affected by the

proposed cuts came and testified about the severe impact of the cuts.

CAPS REJECTED: The Subcommittee, namely Democratic Senators Chesbro, Ortiz,

and Cedillo, voted to reject many of the “enrollment caps” proposed by the

Governor. These programs would have, in the first year, 2004-05, denied:

* care to over 114,000 children applying to get Healthy Families coverage;

* coverage to over 1,250 children with disabilities applying to get into

California Children’s Services (CCS);

* prescription drug coverage to over 1,392 AIDS patients applying to get

covered by the AIDS Drug Assistance Program (ADAP);

* coverage to over 11,430 recent legal immigrants applying to get Medi-Cal;

* prenatal care to over 65,900 undocumented pregnant women and infants, as

well as long-term care to undocumented seniors, applying to get Medi-Cal;

* treatment to 525 immigrants with cancer applying to get into the Breast

and Cervical Cancer Treatment Program in Medi-Cal;

* services to over 35 hemophelia patients and others applying to get into

the Genetically Handicapped Persons Program.

LAO ANALYSIS: The Legislative Analyst’s Office recommended to be reject

these caps, largely on concerns that the caps were difficult to administer,

raise issues of inequity between those on the program versus those on the

waiting list, and may ultimately cost more to the state.

HEATED DEBATE: The debate got emotional at times, especially regarding

testimony about the impact of AIDS patients not getting the life-saving

drugs they need. The discussion among committee members was particularly

heated in an exchange between Senator Tom McClintock and Senator Deborah

Ortiz regarding the enrollment caps to specific Medi-Cal services for both

legal and undocumental immgrants.

CUTS TO PROVIDERS CONSIDERED: The committee also rejected the proposal to

eliminate the “alternative rate method” of paying community clinics, which

would result in a significant cut to those clinics and their ability to

provide for their patients. The committee held open the issue of the

proposed 10% provider rate reductions to all Medi-Cal providers, especially

as court cases are pending on that issue.

DISCUSSION ON DRUG COSTS: There was significant discussion on the issue of

drug rebates, and why the Administration has not done more to raise more

revenue from negotiating with pharmaceutical companies. This was an ongoing

theme throughout the many discussions in a number of programs and areas.

ATTACHED is a UPDATED Health Care Budget Cuts Scorecard. The actions that

the Subcommittee took were a good signal that legislators will not blindly

approve Governor Schwarzenegger’s budget and cut proposals. Yet this is the

beginning, not the end of the debate. Health advocates should continue to

oppose these cuts, as no decision is final until the budget is complete.

U.S. SENATE TO DEBATE FEDERAL BUDGET AND POSSIBLE SEVERE MEDICAID CUTS

U.S. Senate Budget Committee Chairman Don Nickles (R-OK) sponsored a budget

resolution that seeks to cut Medicaid by over $11 billion in the next five

years, along with cuts in other areas. Yet it would increase the budget

deficit, by accelerating repeal of the estate tax and making other tax cuts

permanent. The Center for Budget and Policy Priorities have an analysis at

http://www.cbpp.org/3-4-04bud.htm

Health advocates need to urge our U.S. Senators to vote AGAINST the Nickles

budget resolution and FOR key health amendments that will be proposed in

floor debate later this week, most likely on Wednesday, March 10th, or

Thursday, March 11th. Two amendments of note are:

* an amendment to “strike the ‘reconciliation instruction’” that will force

an estimated $11 billion in Medicaid cuts over five years;

* an amendment that will allow Congress to consider legislation later this

year providing extra help to the states for Medicaid. (This legislation

would continue last year’s increase in the Federal Medical Assistance

Percentage or FMAP. It will continue the temporary aid that California and

other states got last year to help prevent health care cuts.)

CALL CALIFORNIA’S SENATORS TO PREVENT HEALTH CARE CUTS:

Senator Barbara Boxer: 202-224-3553

Senator Diane Feinstein: 202-224-3841

—

Anthony E. Wright

Executive Director

Health Access

1127 11th St., #234, Sacramento, CA 95814

Ph: 916-442-2308, Fx: 916-497-0921

awright@health-access.org