Today Mitt Romney unveiled the last budget proposal of his governorship. It could also be seen as the first budget of Kerry Healy, his chosen successor. Sometimes governors use their budget plan to express policy preferences, chart new directions, or take a stand on key issues. And sometimes there’s Mitt Romney.
While the budget sets markers on tax cuts, education and local aid, on health care, it mostly punts. There’s barely recognition of pending health reform. A blank reserve fund sets aside $200 million for specified purpose other than “health care reform.”
The Uncompensated Care Pool is just missing – nothing there. If this budget were to pass as is, the Pool (which served 400,000+ people last year) would disappear. The key issue of the Medicaid managed care plans and the mental health carve-out is not addressed, even though contracts expire June 30. There’s no mention of a third-party administrator for the MassHealth dental program, even though a court order requires the administration to fund it.
While total MassHealth spending is up 6%, MassHealth policy is status quo. There’s no increase in enrollment for MassHealth Essential, thus maintaining the current wait list of over 11,000 adults below poverty — all eligible and unable to get in because of the cap. Some line items are up (HIV), others down (CommonHealth), but it’s not clear if the numbers mean anything.
On the plus side, some of last year’s wins are continued — affordable CMSP premiums, coverage for senior and disabled legal immigrants. A section appears to provide protections for seniors and disabled in Prescription Advantage. Outreach grants are level-funded at $500,000.
All tobacco settlement revenue is scooped up for general government, while the income tax cut, when fully implemented, would cut spending by over $600 million. Clearly the administration does not expect this budget to pass as submitted. The legislature will fill out the budget in light of health reform, once that’s done.
Every year legislative leaders call the Governor’s budget “dead on arrival.” On health care issues, this budget never seems to have been born.
