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Department of Community Health FY 12 Budget: On Thursday, 26 individuals signed up to provide comments to the House Appropriations Health Subcommittee on the 2012 DCH Budget. Voices provided testimony on the following issues: commending the Governor’s office and leaders within DCH for working to implement family-friendly enrollment and retention processes for Medicaid and PeachCare for Kids while at the same time maximizing opportunities to receive federal funding; expressing concern over changes to the budget that may further restrict access to care for children by proposing a 1% provider reimbursement rate cut and also by implementing copays for children enrolled in PeachCare over age 6; and expressing concern over the proposed $2.9 million cut to the Children 1st Program.

Public Health: HB 214 (Rep. Mickey Channell, 116th District ) Rep. Channell introduced this bill to create a stand-alone Public Health Agency for the state. The bill was heard before the House Health and Human Services Committee earlier this week and received a Do Pass. One amendment was offered by Chairwoman Sharon Cooper, which also was passed, that was to move the Georgia Volunteer Health Care Program our from under Dept. of Community Health to the new Georgia Dept. of Public Health if and when that entity is created under law.

Medicaid Hearings and Appeals: HB 229 (Rep. Sharon Cooper, 41st District) The bill was heard on Wednesday afternoon by the House Judiciary Committee and received a Do Pass. Changes made to the bill before passage out of committee were to decrease from 30 to 10 the number of business days within which the Dept. of Community Health must send a copy of a request for hearing to the Office of State Administrative Hearings.

As advocates for children and families in Georgia, we are concerned about recent attempts within states to scale back vital health care programs for our most vulnerable citizens. The move began with Arizona Governor Brewer’s request to the federal government for a waiver from a regulation that prevents states from cutting some income groups from the Medicaid program. In response, Georgia Governor Nathan Deal’s spokesperson was quoted by Bloomberg news organization earlier today that while the Governor has not offered specific cuts he “would happily work on such a proposal.”

I am certain our governor is aware that Medicaid helps children ages 0-5 whose families are at or below 133% of the federal poverty level (FPL), (for instance, a family of four which earns a little over $29,000/year). It helps children 6-19 whose family earns at or below 100% of the FPL. I find it hard to believe that in these times of high unemployment, lower wages, and increased family stress, that our leadership would embrace restricting medical coverage for what is a growing percentage of our state’s citizenry. Losing a job equates to a loss of employer-sponsored coverage not just for the adult involved, but for the children of the family as well.

In addition, cutting health care coverage would make it harder for kids to access primary care and manage chronic conditions, which in turn would result in poorer health outcomes and greater costs down the line. I would ask the governor’s staff to consider these impacts before making such a seemingly glib remark.

Federal Level:
Yesterday, the U.S. House passed H.R. 2, which would repeal the new health law, the Affordable Care Act. The final vote was 245 for and 189 against. Senate Democrats have indicated that this legislation will not be brought to a vote in the Senate Chamber, which means that the bill will not move any further.

State Level:
Thursday, Commissioner Cook presented the Amended Budget for FY2011 and the proposed Budget for FY2012 for the Department of Community Health. The AFY2011 Budget did not contain many significant changes. Within the SFY2012 budget are the following provisions that may negatively impact children:

• Reduction in Medicaid/Peachcare reimbursement rate by 1% for all providers excluding hospital and home and community-based services (note that budget presentations last year projected a significantly higher reduction rate);
• Implementation of new copayments for PeachCare for Kids members age 6 and older and also for certain members within the Medicaid program; and
• Discontinuation of the Babies Born Healthy Program, which provides for prenatal care for pregnant women who often cannot otherwise access health care services.

The SFY2012 budget also has some provisions that will benefit children in Georgia. For one, DCH indicates an anticipated $6 million in federal performance bonus dollars that will be received once the state implements family-friendly administrative changes to enrollment and retention practices for children within the Medicaid and PeachCare for Kids programs. In addition, the budget includes $10 million in a bond amount that will draw down an additional $90 million in federal match dollars, all of which will be used to make improvements to Georgia’s Medicaid eligibility system.

The Capitol was abuzz today with news that Speaker Ralston has asked the Appropriations Committee to craft a budget that does not rely on the Governor’s proposed provider tax to fund Medicaid. 

 At last week’s budget presentation on her department’s budget, Commissioner of the Department of Community Health (DCH) Rhonda Medows explained that her department had very few budget options.  When Georgia accepted federal funds, it agreed not to cut eligibility or benefits.  Dr. Medows stated that, without additional funds, Georgia would either have to make deep cuts to provider fees or end the Medicaid program.

It is my understanding that Speaker Ralston’s charge to the Appropriations Committee was to find cuts throughout the entire budget, not just DCH’s budget.  Many of us expect that this may lead to even deeper cuts in K-12 education which, adjusted for inflation, will fall to its lowest funding level in a decade in FY 11.

Will this exercise in extracting even more savings from a skeletal budget lead legislators to conclude that they cannot merely cut themselves out of this fiscal situation?  Will they consider revenue measures such as the tobacco tax?  Will there be further cuts to education, child welfare,public health,  juvenile justice, and other programs that ensure that our children have a brighter future?

 We’ll be watching.

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