The growing shortfall in the budget of the Department of Health and Human Services is a serious problem. But lawmakers need answers to many questions before they decide if the governor’s proposed solution is the right medicine.
The first is whether the scope of the problem is really as bad as portrayed. One week, DHHS Commissioner Mary Mayhew told lawmakers there was a $70 million shortfall for the current year. Days later, she said it was more than $120 million.
Gov. Paul LePage has long said Maine’s safety net is too generous and needs to be trimmed back. We hope he is not overplaying a problem to make changes based on ideology.
At the same time, it has long been clear that Maine’s spending — and not just on DHHS — is out of line with revenues. Commissioner Mayhew and her staff are undertaking a thorough and needed review of the department’s operations and spending. This work, obviously, won’t be completed in time for decisions that need to be made about the current budget. This should be a caution to lawmakers to hold off on making drastic changes without seeing the results of this comprehensive review.
In the same vein, legislators should not look at the DHHS budget in a vacuum. It is unusual for a governor to present a supplemental budget for just one department, even a huge one like DHHS. Lawmakers should not make decisions regarding the DHHS shortfall without looking at the budget in its entirety.
For example, should the more than $400 million in tax cuts in the current budget be put on hold to cover DHHS’ bills? Should other departments be cut back and that money allocated to DHHS? Putting DHHS’s funding into a separate silo doesn’t make sense.
Another consideration is whether the governor’s proposed cuts will actually save money. Reducing state funding for DHHS by $120 million this year and $100 million next year will trigger a loss of federal matching funds. Most of the money allocated to DHHS is passed to providers such as hospitals, doctors offices and nursing homes. If the cuts proposed by the LePage administration become reality, these providers will reduce their work forces. This job loss will hit the state’s rural areas, which are already struggling with high unemployment, especially hard.
Further, those who would no longer receive Medicaid benefits aren’t going to suddenly become healthier or wealthier and therefore able to pay for their care. That means that the cost of caring for these people will be passed to those with private health insurance or hospitals will write it off as charity care.
This doesn’t solve a problem, it just passes it to other people.
Lawmakers must carefully examine the priorities within the governor’s supplemental budget proposal. The state does need to build its reserves, but should services to the poor and elderly be cut so that nearly $40 million can go to the state’s Rainy Day Fund, as the governor proposes?
Although the administration has highlighted its proposed cuts to Medicaid for childless adults, it actually cuts funding for nursing homes by a much larger amount. How does this jibe with Gov. LePage’s pledge to protect the elderly? Likewise with the elimination of the Drugs for the Elderly program?
The governor is right that Maine’s Medicaid benefits are too generous. But he has proposed far more than a mere scaling back of those benefits. In fact, many of the changes in his revised budget plan were rejected by the Legislature earlier this year because lawmakers didn’t believe they were appropriate.
They must now decide if the problem has gotten so much worse that such drastic measures are needed. We aren’t convinced they are.