Kaiser Daily Health Policy Report Examines State Budget Developments in Four States

Summaries of recent news about the state budgets in Kansas, New York, Texas and Washington appear below.

• Kansas: State lawmakers on Tuesday approved a $13 billion state budget that includes $1.2 million in new spending to extend coverage under the state's HealthWave program to more uninsured children, the Kansas City Star reports. HealthWave oversees child Medicaid and CHIP beneficiaries in the state. The budget plan passed the Senate by a 35-5 vote and the House by a 71-53 vote and now proceeds to Gov. Kathleen Sebelius (D) for her signature. According to the Star, the new budget is $513 million lower than this year's budget, but it closes next year's projected $680 million deficit (Klepper, Kansas City Star, 3/31).
  
  
• New York: A $131.8 billion budget agreement outlined by Gov. David Paterson (D) and state legislative leaders on Sunday would seek to close the state's budget deficit using billions of dollars in new taxes, financing from the federal stimulus package and $2.3 billion in cuts to health care spending, the New York Times reports. The deal would overhaul Medicaid payment rates to put more spending into preventive care and less into more costly inpatient care, which officials say would save hundreds of millions of dollars annually (Confessore/Hakim, New York Times, 3/30).
  
  
• Texas: The state Senate on Wednesday voted 26-5 to approve a $182.2 billion, two-year budget that includes $61.4 billion for health care, the Dallas Morning News reports. The health care spending includes $45.6 billion for Medicaid, $2.4 billion for coverage for current and retired state employees, $2.3 billion for CHIP and $1.2 billion for health care for prison inmates. State Sen. Bob Deuell (R), the Senate's chief budget writer for health care and social programs, said he tried to rein in health care spending. He said, "We've held it pretty well, considering the costs and caseloads," adding, "It won't be enough to satisfy some people, though." State Sen. Carlos Uresti (D) said the state needs to increase disease prevention efforts. "We don't do enough of that," he said (Garrett, Dallas Morning News, 4/2).
  
  
• Washington state: The state Senate Democrats on Monday unveiled a $32.1 billion budget proposal for fiscal years 2009-2011 that would cut spending by $3.8 billion, including $785 million for health care, to help offset a projected $9 billion budget shortfall, the Seattle Times reports (Garber, Seattle Times, 3/31). Under the Senate budget proposal, spending for Basic Health -- which provides state-subsidized coverage for residents with incomes up to 200% of the federal poverty level -- would be reduced by 42%, which could lead to 50,000 state residents losing coverage. The budget also would cut $190 million from the General Assistance-Unemployable program, which would eliminate health care benefits for up to 3,000 people with disabilities who are unable to work (Ho/Sunde, Seattle Post-Intelligencer, 3/31). In addition, the budget would reduce by $107 million reimbursements to hospitals that provide care for people who cannot pay and cut $38 million in payments for nursing homes (Roesler, Spokane Spokesman-Review, 3/31). The budget also would reduce payment rates for pediatricians, pay less for brand-name medications and reduce premiums to Medicaid managed care companies (Song, Seattle Times, 3/31).