HEALTH ACCESS

HEALTH CARE CUTS ALERT

Tuesday, June 11, 2002

** CONFERENCE COMMITTEE DECIDES HEALTH CARE BUDGET

** Major Care and Coverage Items Saved For Now;

** Significant Cuts in Outreach and Retention

This Tuesday afternoon, the Conference Committee moved quickly and without much discussion to go make major decisions on many of the outstanding budget items regarding health care.

THE GOOD: The Committee rejected some of the major cuts to health care, restoring funds for direct care and coverage to Californians. This included:

* Starting up the Healthy Families parent expansion in October 2002 ($50 mill)

* Restoring basic funds for trauma centers ($25 mill) and the May Revise cut to safety-net hospitals ($31 mill);

* Rejecting the proposal to impose co-pays on Medi-Cal recipients ($30 mil);

THE BAD: The Committee approved some truly awful cuts that would have a direct impact on access to care for hundreds of thousands of California children and working families. The cuts below alone would mean that almost a million people who otherwise would get health coverage will either fall off or never get on. This included:

* Re-instituting quarterly status reports for adults in Medi-Cal ($155 mill, a cut originally rejected by both Assembly and Senate)

* De-funding all school- and community-based outreach, education and enrollment efforts ($7 mill);

* Delaying all “express lane” eligibility efforts until July 2003 ($25 mill);

* Approving drastic Medi-Cal provider rate cuts ($32 mill more);

THE UGLY: Some items remain open, such as whether to fund optional benefits, which has been a source of much discussion on the Conference Committee. (Assemblymember Campbell made a motion to remove medical supplies–things like diabetes test strips–as a benefit. The motion failed.) While the cuts that have been approved by the Conference Committee is are all but final, the fight by advocates to preserve those programs and services that have their funding restored is just beginning. Without a substantial increase in revenues, these programs simply will be cut later in the progress.

More later about a response…

ATTACHED is yet again, an updated legislative scorecard.

ALSO ATTACHED is a list of 80+ organizations in support of upper tax bracket restoration. If your organization is not already on it, or doesn’t have a # next to it, please sign on. In preparation for Monday’s press conference, we are finalizing the list in the next day or so.

Peace,

Anthony

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Additional notes from the last few days from Beth Capell, Health Access legislative advocate:

ACKERMAN’S PROPOSED CUTS: Monday, the conference committee adopted roughly $49.7 million of the cuts proposed by Sen. Ackerman, few in the health area. It is interesting that none of the health cuts he proposed included cuts in eligibility or benefits. (See yesterday for details.)

CAMPBELL’S CUTS? At the close of conference committee on Friday, Sen. Steve Peace, chair of the conference committee, challenged Assemblymember John Campbell, R-Irvine, to offer his lists of $5 billion in cuts needed to close the budget gap without revenue increases. Taken aback, Campbell said that cuts had been offered for months, the cuts were everywhere. Peace pressed him, saying: put together your list of $5 billion in cuts, score it (that is, put a dollar figure next to it), and we’ll vote on it, item by item. It is be the first item of business on Monday morning, giving Campbell the weekend (a lifetime in the world of budget conference committee) to assemble the list. Campbell has presented no such list as yet. Will the Assembly Republicans actually propose $5 billion in specific cuts?

LEGISLATIVE ANALYST’S $5 BILLION CUT LIST: The Legislative Analyst Office (LAO) offered $5 billion in options for cuts, without recommending those cuts but simply to provide the conference committee a list that closed the gap without raising taxes. Almost all of this was rejected and many of the big ticket cuts such as reducing the mortgage interest deduction or the dependent credit were not supported by either Republicans or Democrats. Also rejected on a party-line vote was a $10 million cut in clinic EAPC funding.

HOUSEKEEPING COUNTS: Although this is technically an open conference committee with every single budget item in conference, in practice, it had been hoped that a substantial number of the iterms where the Senate and the Assembly agreed could be voted on in a single motion and thus decided quickly. These include both those items where the Senate and the Assembly agreed with each other but not the Governor and those where all three (Assembly, Senate, Governor) agreed. This is probably 97% of the entire budget, including such basic stuff as the Highway Patrol, the Aqueduct, and every dime of K-12 funding, not the controversial stuff. Assemblymember Campbell withheld his consent. It is not clear whether this is deliberately dilatory, inexperience, or an attempt to review every item in the budget, redoing all the work of the subcommittees. But it will make an already arduous process even harder.



Anthony E. Wright

Director of Organizing

Health Access

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

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

awright@health-access.org

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HEALTH ACCESS

HEALTH CARE CUTS ALERT

Monday, June 10, 2002

* CONFERENCE COMMITTEE CONSIDERS REPUBLICAN CUTS: On Monday, June 10th, the Conference Committee considered scores of motions by Senator Ackerman to cut various programs. Even though the Republican Senator’s recommended reductions only total about $1 billion, he did not come out for the additional $3-4 billion necessary in increased taxes that would still be needed to balance the budget. The list several health items, most of which were not accepted:

MEDI-CAL FRAUD: Senator Ackerman suggested an $100 million reduction by rooting out fraud in the Medi-Cal program. The Administration had already booked savings, and opposed the additional cut. After discussion, the Conference Committee unanimously booked an additional $50 million savings from preventing Medi-Cal fraud.

LA COUNTY HOSPITALS: Senator Ackerman recommended to “eliminate the state share of funding for the Los Angeles County Section 1115 Medicaid Waiver,” saving $30 million a year for five years. The Administration suggested that the federal government would not look favorably on such an action, and could lead to “the collapse of the LA public health system.” Ackerman moved it anyway, which failed with only Republican votes in favor.

MEDI-CAL CO-PAYMENTS: Once again, the Conference Committee had a lengthy discussion on Medi-Cal co-payments, especially the notion that the federal government requires providers to give care regardless if the patient pays the co-payment. Assemblymember Campbell was surprised that there was no data on how many patients, if any, actually paid co-pays in states and situations where they are imposed. His position was that he would oppose them if they are simply provider rate cuts. He agreed with Senator Peace’s statement that “co-pays are good things.” In other words, both Peace and Campbell would support the new Medi-Cal co-pays if they are actually paid by California’s poorest families, but not if they are borne by doctors and hospitals. The issue was left open, as it has been after previous conversations.

MEDI-CAL QUARTERLY STATUS REPORTS: Both the Assembly and Senate sides of the Conference Committee rejected this cut, to require quarterly status reports for Medi-Cal recipients, an $155 million savings which would remove a quarter-million people off Medi-Cal enrollment. Despite the fact that this was an issue that was reject by both the Assembly and Senate Subcommittees, the item was moved to the “re-open list,” to be discussed in the future.

CANCER RESEARCH: Ackerman moved a $13 million cut to cancer research, on top of the previous reductions which cut the funding in half. Assemblymember Steinberg made it clear that with regard to cutting cancer research, “we shouldn’t do it,” and that this should be an important part of the coming conversations on increasing revenues. Senator Ackerman suggested he consider the “larger picture,” including the funding coming from the “federal government” and “other states.”

* SACRAMENTO BEE EDITORIAL: Below is a great editorial that puts starkly the contrast in the budget battle, between health care for working families, or a slight increase in taxes for the wealthiest. http://www.sacbee.com/content/opinion/editorials/story/3162252p-4205838c.html

* CAMPBELL COMMENTS ON HEALTH COVERAGE: Responding to outrageous comments made by Assemblymember Campbell last week in Conference Committee, the Orange County Congregation Community Organization, a member of the PICO California Project, issued a protest. Attached is the terrific press release.



A telling choice

Davis’ budget sacrifices health of poor

Sacramento Bee – (Published June 9, 2002)

You can’t close a $26.3 billion budget gap without making choices, and the choices Gov. Gray Davis has made are telling.

Among the $7.6 billion in spending cuts Davis proposes is one that will dump thousands of needy from the Medi-Cal rolls. Those who manage to keep their health benefits will face more paperwork. Hospitals that serve the millions without insurance will get less support. So will doctors willing to serve the poor.

Because the governor proposes to cut the amount of money the state gives to counties to administer health programs for the poor, Sacramento County would have to lay off 42 workers and close 12 Medi-Cal offices. So even those still eligible for health coverage would have to travel farther to sign up for it. The waiting period for those seeking services would increase to as much as six weeks. As one county official explained it to legislators, it means a poor pregnant woman would be all the way through her first trimester before she’d get her first pre-natal exam — if she could find a physician willing to treat her at all.

The governor proposes to cut what the state pays for the most common Medi-Cal office visits from $24 currently to $18.18. The cut moves California from a dismal 42nd of the 50 states in physician reimbursement to a shameful 48th.

There’s more, but the thrust of it all is the same. The poor, this budget seems to say, not only always will be with us but always will be without health care, too.

There are more equitable ways to close the budget gap, but all of them involve taxes. One proposal, from Senate President Pro Tem John Burton, would raise taxes on the wealthiest 2 percent of Californians, couples with taxable income of $260,000 or more a year. Given federal tax cuts, California’s wealthy would still end up paying less in taxes overall than they paid last year. Apparently that’s not politically tolerable; balancing the budget on the health of the needy is. As we said, the choices people make say a lot about them.



Anthony E. Wright

Director of Organizing

Health Access

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

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

awright@health-access.

Health Access California promotes quality, affordable health care for all Californians.

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