At the end of a long week of poring over Gov. Paul LePage’s proposed two-year budget for the Department of Health and Human Services, lawmakers on the Appropriations and Health and Human Services committees on Friday concentrated on the Fund for a Healthy Maine.
Long considered something of a sacred cow by the public health community, the fund is refreshed each year by about $50 million from the 1998 multi-state settlement with tobacco companies. While the award comes with no strings attached, Maine has several times been recognized for the degree to which it has preserved the fund for public health initiatives in general and for tobacco prevention and cessation programs in particular.
In the mid-2000s, public health groups pushed the possibility of protecting the Fund for a Healthy Maine in the state constitution to keep it from being spent on non-public health programs, but the measure lacked the two-thirds vote needed to pass through the Legislature.
On Friday, it became clear the fund is no longer off limits for general fund uses.
Kathleen Newman, a senior policy adviser to Gov. Paul LePage, told lawmakers that the fund is “the most obvious” source of revenue for the state’s beleaguered Medicaid program, called MaineCare. Thanks to federal provisions related to the Affordable Care Act and the Obama administration’s stimulus funding, Newman said, the LePage administration cannot meaningfully reduce enrollment or coverage in MaineCare and must instead find money to pay for the program as it exists. And she warned that emerging trends and problems in MaineCare may call for even deeper Healthy Maine program cuts ahead.
The budget would free up Healthy Maine funds for MaineCare by eliminating four inspectors in the office of the State Fire Marshal, a coordinator for the adult drug court program, and one and a half positions at the Attorney General’s office.
It axes a forgivable loan program for dental students and a scholarship program for low-income students studying health professions at Maine’s community colleges. It does away with a state-level R.N. consultant for local school nurses and a bone marrow screening program that helps find donors for leukemia patients.
The cuts go on, essentially eliminating residential drug treatment programs and school-based oral and dental health programs. It slashes $15 million out of the Drugs for the Elderly and Disabled program and eliminates funding for family planning and a statewide home visiting program for first-time parents and their babies.
In total, the cuts would carve $18.1 million out of the programs the fund supports.
LePage’s proposed budget also would eliminate a provision that requires the Fund for a Healthy Maine to be used only to supplement, and not replace, funding for existing programs.
Removing the statutory protection of the “supplement, not supplant” language would allow the fund to become a “slush fund” to fill random budget holes, the fund’s supporters say.
The governor’s budget maintains Healthy Maine funding for Head Start, school breakfasts, and childhood immunizations.
The committee room was packed with consumers and advocates whose favorite programs are on the block. Many spoke in passionate defense of the services they receive.
But Becky Smith, who represents a group of more than 150 public health and social service agencies called the Friends of the Fund for a Healthy Maine, told lawmakers that LePage’s budget plan violates the legacy of the Fund for a Healthy Maine itself, leaving it vulnerable for future raiding for purposes unrelated to promoting the health and safety of Maine people.
“Today, the importance of the fund could not be more apparent — Maine’s economy depends on bringing down the cost of health care for the state and for business, and that’s what the Fund for a Healthy Maine is designed to do,” Smith said. “Yet here we are today talking about a sizable cut and complete dismantling of the fund.”
Work sessions for the Health and Human Services budget have not yet been scheduled. Next week’s hearings before the Appropriations Committee move on to proposed budgets for the departments of Education, Agriculture and Public Safety.
An earlier version of this story incorrectly reported that Gov. LePage's budget would maintain funding for a statewide home visiting program for first-time parents. The governor's budget would in fact eliminate all funding for the program, as correctly reported below.