Kaiser Daily Health Policy Report Highlights Budget Developments in Four States

Summaries of recent news about state budget proposals in Florida, Massachusetts, Minnesota and New York appear below.

• Florida: Florida lawmakers in both chambers last week approved budget proposals that "all but guarantee a record $4 billion to $5 billion in wide-ranging cuts," including several to health care services, the Miami Herald reports (Fineout, Miami Herald, 4/4). The Senate's $65.9 billion budget plan represents a decrease of about $4 billion from this year's budget, while the House plan is about $800 million below the Senate plan (Kaczor, AP/Florida Times-Union, 4/9). Medicaid reimbursements to hospitals would be cut by $200 million under the Senate plan and by $330 million under the House plan. The House would eliminate coverage of hospital care from the state's Medically Needy program, which would save the state $170 million. The Senate plan would limit the program to children and pregnant women, which would save about $350 million by eliminating 16,000 beneficiaries from the program. Nursing homes' Medicaid reimbursements would be reduced by $164 million under the Senate proposal and by $278 million in the House proposal. The Senate bill would save $355 million, including federal dollars, by eliminating a Medicaid program that covers 24,000 disabled and elderly state residents. The House would cut $5 million from Healthy Start programs, which would block 11,580 women and infants from receiving immunizations and pre- and postnatal checkups. In addition, the Senate plan would cut $24.8 million in spending by eliminating hearing and dental services for low-income adults (Kennedy, Orlando Sentinel, 4/7).
  
  
• Massachusetts: Gov. Deval Patrick (D) last week requested that executive branch department heads identify budget cuts totaling at least $150 million in the event that state tax revenues do not remain at anticipated levels, the AP/Boston Herald reports. The state faces a $1.3 billion structural budget deficit, due in part to higher-than-expected enrollment in health care programs. Secretary of Administration and Finance Leslie Kirwan, in a memo to department heads, issued a series of immediate spending controls including prohibiting additional funding requests for the current fiscal year; prohibiting payments that could result in the deferment of federal reimbursements, suggesting that no vacancy be filled for the remainder of the fiscal year; and limiting transfers within departments and between agencies. According to Kirwan, the state is facing other budget challenges, including possible deferrals of some federal Medicaid reimbursements. House Speaker Salvatore DiMasi (D) has proposed closing the budget gap through an increase in the state cigarette tax, spending controls and using money from the state's rainy-day fund (Johnson, AP/Boston Herald, 4/4).
  
  
• Minnesota: The state House and Senate on Thursday debated different but similar bills to close a projected $935 million state budget deficit, the Fargo Forum reports. Under the lawmakers' plans, which would close the gap by different means than Gov. Tim Pawlenty's (R) budget plan, most state agencies would have to cut their budgets by 3% to 4%, according to the Forum. House Health Care and Human Services Finance Division Committee Chair Tom Huntley (D) said, "We do have severe cuts to hospitals," adding, "That is the only thing I could do in this bill to protect nursing homes and long-term care facilities." The House bill includes $45 million in cuts to hospitals, which would result in a $90 million loss for hospitals because federal matching Medicaid funds would be reduced, according to Huntley. Both the House and Senate bills include more money for nursing homes than proposed by Pawlenty (Davis, Fargo Forum, 4/4).
  
  
• New York: The New York Legislature on Wednesday approved a $122 billion state budget proposal that would increase overall spending by nearly 5%, Long Island Newsday reports. The proposal would increase Medicaid spending 1.2% compared with a decrease in spending last year. The proposal also includes money for health insurance for low-income children (Madore, Long Island Newsday, 4/10). In addition, $37.2 million will be split evenly between the state Senate and Assembly for discretionary health projects (Odato, Albany Times-Union, 4/9). The budget increases would be funded by a $1.5 billion total increase in taxes and other fees, including a $1.25-per-pack cigarette tax increase. Gov. David Paterson (D) is expected to sign the budget (Peters, New York Times, 4/10).