Deal’s budget cuts will trim health programs

Gov. Nathan Deal’s budget proposals, unveiled Wednesday, contain financial pain for Georgians in government insurance programs and those who treat them.

Medical providers such as physicians will receive a 1 percent cut in payments for treating Medicaid and PeachCare patients in fiscal 2012. That reduction, which does not affect hospitals, was not as harsh as anticipated.

But Medicaid beneficiaries will face higher co-pays, and adults in the program will lose vision, dental and podiatry benefits. Parents of children in the PeachCare program for uninsured kids will be required to pay co-pays for the first time. These changes will create barriers to needed care, consumer advocates warned.

Deal’s first State of the State address Wednesday focused on budgets for the current fiscal year and fiscal 2012, which begins in July. He also criticized federal health care reform legislation in his speech to Georgia lawmakers.

The reform law, Deal said, “will greatly add to the burden that we face. In fact, it will add approximately 650,000 Georgians to the Medicaid rolls. This mandated expansion of service will cost Georgia Medicaid an additional $2.5 billion in state funds alone over the next ten years.’’

Deal complained about federal requirements that don’t allow the state to change its eligibility rules for people to enroll in Medicaid. ‘’Left unaddressed, we expect to see patient access to care severely limited and an overall erosion of the high-quality care that our state prides itself upon,’’ Deal said.

One health care arena came out way ahead in the Deal budgets: Georgians needing mental health or developmental disabilities services will see a big increase in funding for community programs, under the state Department of Behavioral Health and Developmental Disabilities. That change stems from a settlement that the state reached with the U.S. Department of Justice last year.

Under the DOJ accord, Georgia promised to deliver $77 million in new funding to help people with disabilities avoid institutionalization by offering more community alternatives such as housing and crisis teams.

“It’s a good amount of money,’’ said Ellyn Jeager, director of public policy and advocacy for Mental Health America of Georgia. “Now the department must be sure that it’s spent in the most appropriate way to get the best outcome.’’

Public health, though, appeared to be a major budget loser. Public health services take an $8.7 million cut in state funding, or a 6 percent reduction, said Tim Sweeney, senior health care analyst at the Georgia Budget and Policy Institute (GBPI). That decrease comes on top of public health cutbacks in previous years.

Deal, in his address, also vowed to eliminate 14,000 government positions overall, and state health agencies will bear their share of those cuts.

The budget documents project a decrease of about 250 jobs in the Department of Community Health, which runs Medicaid and PeachCare, and about 770 positions in the Department of Behavioral Health and Developmental Disabilities.

Behavioral Health spokesman Tom Wilson said the job cuts there will reflect reductions in state psychiatric hospital employment in the coming year as community services increase. “For instance, by June 30 of this year we’ll stop admitting any new people to state hospitals whose primary diagnosis is a developmental disability,’’ Wilson said. “At the same time, we’re transitioning out 150 people with developmental disabilities by July,’’ he said.

The budget shows state employees and teachers in the state’s health benefit plan will face a 10 percent hike in insurance premiums in 2012, mirroring one that took effect this year.

The unexpectedly small cut in Medicaid payments to physicians and other medical professionals was welcome news, said Jimmy Lewis, CEO of HomeTown Health, an organization of rural hospitals in the state. “It’s pretty clear that [Deal] acknowledges some of the access and funding problems we’ve had in the Medicaid program. He has attempted to protect access to care and providers as much as possible.’’

Sweeney of GBPI said, “Hopefully, medical providers can handle a 1 percent cut, and we won’t see a reduction in access.’’

Still, Cindy Zeldin of the consumer group Georgians for a Healthy Future predicted that the Medicaid rate cut, the new PeachCare co-pays, increased Medicaid co-pays and the elimination of some Medicaid benefits ‘’will all negatively impact access to care.’’

“Eliminating basic services like dental and podiatry can lead to greater medical problems that could have been treated early on,’’ said Zeldin. She said the government should look for ways to increase revenues to prevent such health care reductions.