Health care players decry cuts pitched in Washington
Debt targets include Medicaid, Medicare
More than 50 state health care workers, executives, union activists, and lobbyists gathered on Beacon Hill yesterday to protest anticipated federal funding cuts they say would squeeze the state budget and devastate a business sector key to the Massachusetts economy.
While members of the hastily assembled coalition said they were still tracking fast-changing budget talks in Washington, D.C., some estimated the cuts being contemplated could drain $1 billion to $3 billion in annual health care funding from the state’s $30 billion budget, hurting everyone from the poor and elderly to doctors-in-training at teaching hospitals.
Standing on the State House steps, coalition members represented organizations including the Massachusetts Hospital Association, the Service Employees International Union, the consumer group Health Care for All, and the Greater Boston Interfaith Organization. Many held signs that read, “Fed cuts hurt care and jobs.’’
Speakers said that while it is difficult to gauge the full impact of fluid debt-limit negotiations, Massachusetts is almost certain to take a disproportionate hit because it collects additional federal money for a range of services, including training for medical residents and support for urban hospitals that treat large numbers of low-income patients.
“We are really scared and concerned about what might happen if Congress acts rashly and uses health care as the whipping boy’’ to rein in spending and reach a deal on raising the debt ceiling, said Lynn Nicholas, president of the Massachusetts Hospital Association in Burlington. “Medicare and Medicaid already don’t pay for their share of the costs.’’
The event, billed as a press conference, had the trappings of a political rally. It drew support from powerful health care players who are sometimes on opposite sides of the table, such as Partners HealthCare System, which operates the Harvard-affiliated Brigham and Women’s and Massachusetts General hospitals, and Blue Cross Blue Shield of Massachusetts, the state’s largest health insurer. All of them said they worry that federal cuts could negate gains from the state’s 2006 health care law and derail efforts to overhaul health care payments.
Not everyone shares that concern. Andrew Roth, vice president of government affairs at the Club for Growth, a Washington group that supports lower taxes and limited government, said government must lift the burden on taxpayers. He said he wasn’t surprised Massachusetts health care organizations that depend on government spending are opposing cuts.
“If you rob Peter to pay Paul, you are always going to get Paul’s support,’’ Roth said. “What we need is to cut back on spending to get our economy growing.’’
President Obama’s deficit reduction proposal, aimed at reaching a deal to raise the US debt ceiling, would reduce federal health care spending by about $340 billion over 10 years. That would be in addition to about $155 billion in projected cuts to Medicare, the government program that insures seniors, under the federal health care law passed last year. Proposals from congressional Republicans include far deeper cuts.
The additional Medicare cuts would likely mean an estimated $322 million reduction in spending on medical resident training, a blow to teaching hospitals affiliated with the state’s four medical schools.
But the biggest hardship for Massachusetts, coalition members said, is likely to come from a reduction in federal funding for Medicaid, the health insurance program that covers low-income residents and is an important source of revenue for urban hospitals such as Boston Medical Center and Cambridge Health Alliance’s Cambridge Hospital. The cuts could affect the additional federal funding such hospitals expect to get between 2012 and 2014 under a so-called waiver program for institutions heavily dependent on government payers.
Among the proposed Medicaid cuts is the elimination of taxes on health care providers that get matched by federal money. Massachusetts collects about $600 million each year through taxes paid by nursing homes, providers, and insurers. That money is paid into the state’s general fund, but much of it is returned to Medicaid programs and matched dollar-for-dollar by the federal government to pay for programs, including subsidized insurance for low-income patients. Critics of the taxes say they are a ploy to draw more federal dollars.
If the taxes are eliminated, the state’s Medicaid program could lose as much as $1.2 billion, about 10 percent of its budget, said Massachusetts Medicaid director Terry Dougherty.
Nadia Vilmont, a patient access representative at Boston Medical Center and a member of Local 1199 of the Service Employees International Union, told those at the State House event that Washington politicians were asking patients to pay for “economic mismanagement.’’
“The middle class has already tightened their belts in this challenging time,’’ Vilmont said. “At Boston Medical Center, we care for the very people that right now seem to be invisible to the folks in Washington, D.C.’’
Another speaker, the Rev. Hurmon Hamilton, the pastor at Roxbury Presbyterian Church and the president of the Greater Boston Interfaith Organization, likened the Washington impasse over lifting the debt ceiling to a game of “Russian roulette’’ with potentially disastrous repercussions.
“This is not a benign game that has no consequences,’’ Hamilton said. “This is not a video game where you can drive recklessly off a cliff and then push ‘start again.’ ’’
Chelsea Conaboy of the Globe staff contributed to this story. Robert Weisman can be reached at firstname.lastname@example.org.