With a nearly $6 billion projected deficit, there is going to be a lot of tough decisions when it comes to Washington State's budget. In the area of health care, it will be a battle to maintain the progress made in recent years. Details and certainly revisions will follow in the next couple of months, but Robby Stern from the Healthy Washington Coalition recently sent out an email with some of the highlights when it comes to health care:

First some good news:

-          The budget maintained dental, vision & hearing for Medicaid adults and kids (up to 250% of poverty). Mental health parity was retained for medicaid adults and kids.

-          There was about a $40 million increase in grants for uninsured care at community health centers.  Sadly, this also acknowledges that this budget will lead to a dramatic increase in the number of uninsured people in WA.  

-          State portion of funding to Public Health was maintained. However, local funding has diminished enormously so that our Public Health infrastructure is in big trouble.        

Now for the bad news:

-          42% cut in funding to the BHP. The Director of the Health Care Authority was charged by the Governor to look at benefit design, cost sharing, & administrative efficiencies before cutting enrollment. Our Coalition partners at the Community Health Clinics estimate this will lead to up to a 6% increase in the number of uninsured in WA “vitually overnight”.

-          The GA-U medical and grants program is eliminated. GA-UX, who are the people on SSI and the most vulnerable (i.e. aged, blind, disabled) were maintained.

-          There is a 4% cut in both in-patient and out-patient hospital reimbursement. This cut will not apply to psychiatric hospitals.

-          Healthy Options premiums were reduced by 1% in the first year and there was an assumption of no growth in the second year. This will impact managed care programs (Molina & Group Health) that provide care for Medicaid children and maybe (I am not sure of this) some Medicaid adults.

-          Funding for the Health Insurance Partnership to assist small business employees and their employers was rescinded.

-          Funding for the 6333 Working Group was eliminated.

-          Funding for foster kids leaving foster care was eliminated.

In all, $990 million was cut out of the health care budget or about 12% of health care spending.  It would have been worse but for the fact that the Governor assumed an additional $1 billion from the feds. in increased Medicaid match, increased SCHIP (Children’s Health Improvement Program) funding and increased TANF funding. The budget also achieved savings by eliminating raises that had been negotiated for state employees in the recently completed collective bargaining process.

The future we all want for WA is not in this budget. People in our state want more people to have secure, quality, affordable health care, not less.

The cuts in the budget will only make matters worse. These cuts will lead, inevitably, to more uncompensated care and therefore more cost shifting to those who are lucky enough to have coverage; residents of our state getting sicker because they cannot access primary and preventative care; ERs being inundated with the uninsured and under insured also impacting the quality of emergency medicine that can be delivered; and an inevitable escalation of health care costs.