Wednesday, August 20, 2008

On The Backs Of The Poor

We're now into the 51st day of the new fiscal year, and California still doesn't have a budget. Frankly, I don't see one emerging any time soon. The problem is that the state has been operating in the red for several years, and we now have a serious deficit facing the state during really dicey economic times. Because state voters foolishly bought into a Republican scheme to keep taxes low for the wealthier and for businesses, it takes a super-majority of the legislature to raise or introduce taxes. This means that the budget has to be balanced somehow, and the somebodies who are asked to carry that load are those who receive state services: the poor, the sick, the elderly.

One emergency measure passed by the legislature involved reducing Medi-Cal payments (the state's Medicaid program) to medical providers 10% effective July 1. Since nearly half of the physicians in California refuse to take Medic-Cal patients even under the old reimbursement schedule, the practical effect of the cut would be to move more physicians out of the program.

According to this article in today's Sacramento Bee, however, a federal judge has issued a temporary injunction halting the reduction.

A federal judge has ordered a temporary halt in the state's 10 percent reduction in Medi-Cal reimbursement rates, improving access to care for 6.5 million low-income patients but throwing a new wrench in already difficult budget negotiations.

The U.S. District Court decision forces the state to reimburse most Medi-Cal providers at rates prior to the 10 percent cut, which lawmakers and Gov. Arnold Schwarzenegger made effective July 1 as a cost-cutting measure to help resolve a $15.2 billion budget shortfall this year. ...

But the injunction comes as lawmakers remain divided because they cannot agree whether to bridge the budget spending gap with new taxes, borrowing or spending cuts. If the state ultimately loses the Medi-Cal reimbursement case, it could face an additional $575 million hole on top of the $15.2 billion deficit, according to Schwarzenegger's Department of Finance.

Now, one of the curious parts about the measure is that the Democrats (who control the legislature except when it comes to raising taxes) went along with it. Whatever were they thinking? I mean, the Democrats in Congress rolled back a similar measure embedded in a Medicare bill just about the time California's bill took effect. Weren't our state officials paying attention?

But even more curious is the fact that at least one Republican state legislator thought the idea wrong-headed because of the impact it would have on health care access and voted against it:

Sen. Sam Aanestad, R-Grass Valley, an oral surgeon and one of the few GOP legislators to oppose the cuts in February, applauded the judge's decision.

"It looks like the judge recognized that these people have no access, and certainly not equal access to services, at least not the way the (federal) program was envisioned."

As much as stupidity and mean-spiritedness abounds in Sacramento right now, at least one man gets it, and he happens to be a Republican.


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