May 26th, 2009

The Philadelphia Inquirer ran the following op-ed by Ken Braithwaite, regional executive of the Delaware Valley Healthcare Council and senior vice president of the Hospital & Healthsystem Association of Pennsylvania, and Laval Miller-Wilson, executive director of the Pennsylvania Health Law Project. The piece ran on Monday, May 25, 2009.

The Pa. Senate passed a budget that is a big step back in caring for the disabled and ill.

The American health-care system needs to change. But with more than 8 percent of Pennsylvanians out of work, government cuts that would weaken the health-care safety net are not the changes we need.

Last year, the number of Pennsylvanians covered by Medical Assistance – the state’s version of Medicaid insurance for low-income residents – rose at three times the expected rate. In a little more than a year, the region has seen a 10 percent increase in Medical Assistance enrollment. Hospitals report more people turning to their emergency rooms for health care. And government-subsidized health centers are caring for more uninsured people.

But the budget plan recently passed by the state Senate – and, to a lesser degree, the one proposed by Gov. Rendell – would reduce health-care services for those who need them most.

The Senate’s budget would eliminate additional proposed subsidies for low-income families purchasing health coverage through the Pennsylvania Children’s Health Insurance Program. It would also put about 2,000 older Pennsylvanians in nursing homes, costing taxpayers twice what it would to keep them safe and comfortable at home with community-based services.

The Senate legislation would make large cuts to Medical Assistance, including funding for essential services such as obstetrics. Many of these reductions would fall on people with disabilities, denying them the services they need to lead independent lives.

By reducing support for screening and prevention, the proposal could also delay detection and treatment of cancer and other serious diseases.

Both budget proposals also mean cuts for hospitals. In the best of times, Pennsylvania hospital margins are about 4 percent, on average. Today these margins have fallen off a cliff, having dropped an unprecedented 12 percentage points in two years.

The Senate’s budget would exacerbate hospitals’ financial challenges by cutting Medical Assistance payments by about $280 million (nearly 10 percent), $167 million in the Philadelphia area alone. The governor’s budget calls for a reduction of $75 million statewide and $40 million in the region.

These cuts would result in more job losses. This year, one Philadelphia hospital has already closed its doors as a general acute-care facility. More may well follow.

The saddest aspect of these cuts is that they are totally unnecessary. Pennsylvania is eligible for up to $4 billion in additional Medicaid funding from the federal stimulus package. For every dollar the state spends on Medical Assistance, the federal government contributes about $1.60. To maximize its share of federal stimulus dollars, Pennsylvania must fund Medical Assistance, not cut it.

We urge the public to oppose cuts to Medical Assistance and other health-care safety-net services. Please tell your local and state representatives that you reject any reductions to these services in next year’s state budget.

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Ken Braithwaite is regional executive of the Delaware Valley Healthcare Council and senior vice president of the Hospital & Healthsystem Association of Pennsylvania. Laval Miller-Wilson is executive director of the Pennsylvania Health Law Project. Their e-mail addresses are kbraithwaite@dvhc.org and lmillerwilson@phlp.org. Seven other health-care advocacy groups join in their opinion.