Progressive Triumphalism Is Premature

Under Democratic and Republican governors alike, and with the cooperation of a supposedly progressive legislature, Massachusetts is defunding human services and education and prioritizing corporate welfare.
This casual contempt for the less fortunate among us continues.  On December 4, the Governor announced further cuts under his 9C powers (which do not require legislative approval):
Lower reimbursements for districts with high-needs special education students (via $11.5 milllion in cuts to the SPED Circuit Breaker).

A 46 percent cut to a new program that helps reimburse local school districts for transporting homeless students to and from school.

A 1 percent cut to Local Aid, which funds municipal services including police and fire protection, parks, and public works. (This cut would have to be approved by the legislature.)

$7.4 million in cuts to mental health programs, including some services for children and some for adults.

Programs administered by the Department of Children and Families were cut by more than $7 million, including a $5.2 million cut to residential care.

The Employment Services Program was cut $79,000, reducing its funding level to 76 percent below its pre-recession level. The program provides education, occupational skills, and employment support services to low-income families with children.
$3.7 million in funding for Law & Public Safety programs.

About $128 million in total cuts and savings to MassHealth. Since Massachusetts receives a 50 percent federal reimbursement for most MassHealth spending, the net savings for the state amount to roughly half of this total. The administration also expects to tap the Commonwealth Care Trust Fund (CCTF), since FY 2013 costs for the Commonwealth Care program are expected to be lower than originally projected (companion legislation filed with the 9C cuts would allow the administration to reduce the transfer from the General Fund to the CCTF, but no amount is specified).

This latter will disproportionately affect lower-income patients, as Paul Levy, the ex-head of Children’s/Deaconess Hospital explains:

“So, in total, the Massachusetts reimbursement system is systematically being pared back to a level that will not permit many hospitals to cover their costs.  The ones that will be most vulnerable will be the hospitals serving the most vulnerable, the safety net hospitals, who derive a large percentage of their income from Medicaid.  But other hospitals will be hurt as well (except for the lucky system whose market power provided above-market private insurance payment rates.)

“Here’s the big picture prediction for Massachusetts and other states watching the Massachusetts experience:  Continued concentration of the hospital industry to create a larger referral base and to gain market power over the insurers.  But the safety net hospitals will be left out of those deals, for fear they will be a drag on earnings since such a large portion of their revenues is subject to state appropriations.  The ironic end result: A growing disparity in the level and quality of hospital care offered to the poor, precisely at the time the poor are given greater access to health care services.”

On generic matters, Massachusetts has one of the highest levels of gender-based pay disparity in the nation, and Boston is second in the country for hate crimes (first in the nation if population is considered).

Given this, I think that progressive triumphalism in Massachusetts is a trifle premature.

—Paul Simmons





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