No budget deal announced yet, as many of us await news of a deal.
The biggest concern is whether such a deal includes a spending cap, which has potential to do severe damage not just now, but into the future, forever.
A spending cap, like the ones the Republicans have proposed in the legislature, would not just prevent future additional spending on health care and other vital services: it would certainly force cuts in the future.
Our health care system would be especially savaged by a spending cap.
By definition, the point of a spending cap is to prevent more spending–but even to areas where we have underinvested. A spending cap would lock us in to:
* the lowest per-patient Medicaid spending in the nation,
* over 6 million uninsured Californians,
* and the current broken health system for all of us, preventing increased Medi-Cal provider reimbursement rates, coverage expansions, or other reforms and improvements, and investments of our shared health system.
But a spending cap wouldn’t just prevent progress, but it would inevitably force cuts into the future. Even indexed for inflation and population growth, a cap won’t take into account:
* medical inflation, which typically goes up at a rate greater than regular inflation. Even public programs, which do a better job in keeping costs down than private health coverage, would be forced to; and
* the aging of our population, a significant trend which will put a greater strain on health and human services in California and nationwide.
In addition, health and human services lacks the protections that other parts of the budget have, making these programs even more vulnerable.
A cut in health care this year will be horrific, especially during these economically tough times when the need is greatest. A spending cap is going nuclear, preventing any recovery in the future.
We’ll be watching…