The more information that comes out about the Department of Health and Human Services budget, the more it becomes obvious that a lot more work needs to be done before any decisions about budget cuts can be made.
In a report to lawmakers late last week, DHHS detailed the reasons for the $120 million shortfall in the current fiscal year and an expected $100 million shortfall next year. Those reasons are very different from the rationale used by the governor to try to justify major cuts he has proposed.
Gov. Paul LePage has proposed a sweeping overhaul of the MaineCare program that would eliminate coverage for 65,000 residents and reduce services for many others to close the budget gap. He blames a big jump in MaineCare enrollment for most of the shortfall. More recently, he blamed fraud.
While increased enrollment in MaineCare is part of the reason, it pales in comparison to errors and faulty assumptions made when the biennial budget was being put together earlier this year, according to the report from DHHS Commissioner Mary Mayhew.
Growth in the number of people seeking services under MaineCare accounts for about 3 percent of the shortfall. A much bigger problem is that DHHS didn’t properly account for costs associated with private nonmedical institutions, known as PNMIs, like nursing homes and residential facilities for the disabled. Another error is that some costs for last year ended up on this year’s ledger, but money was not set aside to pay them.
Asked during a Bangor Daily News editorial board meeting earlier this month why there was such a big shortfall, Commissioner Mayhew said: “The budget set for 2012 was too low even if the number of people and services stayed the same.” She then went on to list — in order — other reasons: the computer problems that caused the delay in claims from last year to this year; the cost of the state paying some Medicare premiums for some of the state’s low-income elderly residents; the PNMI problem; and increased MaineCare enrollment.
This paints a far different picture than that crafted by Gov. LePage, who continues to blame rising enrollment, too generous benefits and now fraud for the budget shortfall.
He’s right that enrollment in MaineCare is unsustainable, although much of the recent growth is likely due to the current economic situation. He’s also right that many of Maine’s benefits are too generous. These are problems, however, that must be dealt with over time and in light of all the state’s spending, not just the DHHS budget.
Plans also need to be made to deal with the consequences of cuts, because people who rely on MaineCare won’t suddenly be healthier because their health care will no longer be covered by the state. They will end up in emergency rooms with their care paid for by hospitals and people with private health insurance.
Miscasting a budget problem in order to quickly make changes to fulfill an ideological agenda is politically disingenuous. Doing so at the expense of the state’s most vulnerable people — without plans to help them and their families through the changes — is callous.
The Appropriations Committee must find a better way.