Baldacci feeling pressure on Medicaid cuts

Wednesday, March 24, 2004

By PAUL CARRIER, Portland Press Herald Writer

AUGUSTA — Opposition is growing in the Legislature to a series of highly controversial Medicaid cuts proposed by Gov. John Baldacci, who is now expressing reservations about his own plan.

But it's still too soon to tell if the governor's bid to eliminate more than a dozen health-care services for adults can be averted.

The Legislature's Health and Human Services Committee, which oversees the Medicaid program, has come out against the cuts. Members argue that the state should find ways to rein in Medicaid spending for 15 services instead of completely eliminating them from the Medicaid program to save $9.5 million, as Baldacci has proposed.

At the same time, Baldacci wants to avoid the cuts if other savings can be found, according to spokesman Lee Umphrey. He said Baldacci has instructed Trish Riley, director of his Office of Health Policy and Finance, to look for alternative ways to save money, but Baldacci has ruled out tax hikes as an option.

The governor said last week he now wants to preserve at least some Medicaid funding to rehabilitate people with brain injuries, which is one of the 15 services he originally proposed eliminating. Baldacci also has expressed general support for the other threatened services, although he has not backed away from his budget.

The $160 million supplemental budget that Baldacci has submitted to the Legislature for the fiscal year starting July 1 is designed in large part to eliminate a $127.7 million shortfall in the Medicaid program. The budget includes more than $80 million in Medicaid cuts, the most controversial of which would drop 15 adult services from the program.

In addition to brain-injury rehabilitation, some of the other services that would be dropped from Medicaid under the governor's budget include dental care, occupational therapy, speech and hearing services, podiatry, physical therapy, optometry, prosthetics and psychological services.

The governor's plan attracted an overflow crowd March 15 when the Legislature's Appropriations Committee held a hearing on the proposed Medicaid cuts. More than 1,000 people were at the Augusta Civic Center that day to condemn the cuts, with much of the testimony focusing on the importance of preserving rehabilitation for people with brain injuries.

The next day, Baldacci told reporters he might be willing to consider raising taxes as a last resort to balance next year's budget, but he reversed himself Wednesday, telling reporters tax hikes are off the table.

Umphrey reiterated the governor's opposition to tax hikes Tuesday, saying Baldacci wants Riley to look for alternatives that would preserve the threatened services without raising revenues.

"He's asking Trish (Riley) to revisit it with any alternative except taxes," Umphrey said of Baldacci. Umphrey said the governor has told Riley to "go back to the drawing board, review what we've done so far and see if there are other ways to do that" without dropping 15 adult services.

In doing so, Baldacci is reacting not only to pressure from consumers and health-care providers but also to significant opposition in the Legislature.

"I don't see any sentiment anywhere in the Legislature to eliminate services," said Sen. Michael Brennan, D-Portland, who co-chairs the Health and Human Services Committee. The state should do a much better job of controlling access to such services, Brennan said, but he said opposition to the outright elimination of services is so strong that the governor has no choice but to look for alternatives.

"I think it's absolutely irresponsible to eliminate services when you are proposing new positions" in state government, said Rep. Darlene Curley, R-Scarborough. who serves on the Health and Human Services Committee. The governor's proposed budget would create about 94 new state jobs, according to the Legislature's budget office.

The fact that Democrats and Republicans alike on the Health and Human Services Committee want to preserve the threatened services is a good sign, said Betsy Sweet, a lobbyist for social workers, occupational therapists and other interest groups that would be affected by the cuts.

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