The Salem News
Thursday, January 30, 2003
Medicaid 'BMW' needs trip to repair shop
By Taylor Armerding
A fiscal crisis is a very unpleasant thing. But it does have
its good points, such as bringing a bit of reality to public discourse.
Consider the Medicaid trial balloon of state Rep. Harriett
Stanley.
Stanley and I sometimes disagree. OK, we usually disagree.
But for the moment, I'm her biggest fan.
The West Newbury Democrat said things a week or so ago that
most of her colleagues, whose compassion knows no bounds when it comes to paying for it
with your money, wouldn't say unless they were injected with truth serum.
She says Medicaid recipients ought to contribute at least
something to its gargantuan cost, either through modest co-payments or monthly premiums.
She wants them to view it "as more of an insurance program than an entitlement program."
That's radical enough. But wait, there's more:
"You don't value what you don't pay for," Stanley says. I'm
wondering: Has she been talking to my mother?
But wait, there's even more:
Stanley calls MassHealth the "BMW of Medicaid systems" and
suggests more people could be covered at a lower cost if the program were not so lavish --
more like a Ford.
Where, oh, where, was Stanley or anybody in the Legislature,
or the administration, who would have labeled the MassHealth program a "BMW"
until now?
Why was it Barbara Anderson, head of Citizens for Limited
Taxation, rather than the members of the Legislature, declaring years ago that the Medicaid
program was an impending "train wreck." Why is it only now that people in
charge of the Massachusetts purse strings are noticing that Medicaid, at
about $6 billion a year, is consuming more than a quarter of the state budget and still
growing like kudzu?
Actually, Stanley says former state Sen. Patricia McGovern,
the Merrimack Valley Democrat, predicted the fiscal meltdown of MassHealth back when she
was Senate Ways and Means chairman in the 1980s.
But whoever saw it coming, nobody did anything about it.
Stanley says that during the past decade, rather than
looking for ways to control costs, Massachusetts was busy adding hundreds of thousands to the
Medicaid rolls. From 1996 to the present, Medicaid enrollment in Massachusetts swelled
from 650,000 to more than a million.
So it shouldn't be a shock that, as she puts it, "We make it
easier to get on (Medicaid), easier to stay on, and we offer a Medicaid package that is better
than a lot of private baseline health plans."
Nor should it be a shock that about $1,000 of the state and
federal taxes paid by every man, woman and child in Massachusetts goes to support Medicaid.
Nationally, there are now more people on Medicaid than elders on Medicare.
Given the current climate, there is hope that Stanley's
pitch will get at least a respectful hearing, not that I'm holding my breath. There are already
complaints that any contribution from recipients will take food from the
mouths of children. We are already hearing of the fraying safety net, of
blood in the streets, of balancing the budget "on the backs of the poor."
"This is not going to be easy," Stanley admits "It took us
20 years to get into this, and it may take 20 to get out of it."
Let's hope not. We can't afford it. It is long past time for
even the poor to think that health care is free, and that poverty is an excuse to avoid financial choices.
I have my own anecdotal evidence, in a close acquaintance
who has been on MassHealth for 15 years. He lives in subsidized housing and uses his monthly
welfare check for, among other things, a cell phone, cable TV, Internet access
and bottled water.
Yet he tells me he can't afford, and shouldn't have to pay,
even a small health insurance premium or co-payment.
Sorry, I don't buy it. And nobody else should either.
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The Boston Globe
Friday, January 31, 2003
A Boston Globe editorial
Cutting to the quick
Mitt Romney presented himself on television Wednesday as a
governor who would not sugarcoat the state's economic plight but would still defend the
government's "core missions." Yesterday, however, his two top lieutenants
detailed cuts that can damage essential services.
As described by Lieutenant Governor Kerry Healey and
Administration and Finance Secretary Eric Kriss, the budget cuts affect a range of services,
especially in health care, and come on top of earlier reductions by the
Legislature and the Swift administration. Healey and Kriss said cities and towns
will lose $114 million in direct local aid, and while this is less than the $200
million cut that Romney had considered earlier this month, it is still a heavy
blow this late in the 2003 fiscal year, which is more than half over. Healey and
Kriss offered a series of administrative improvements as compensation. Many
of these have merit, but all require legislative approval and would have little
impact immediately.
While Romney cushioned the blow to local aid, he hammered
away at the Medicaid program. During the campaign he won points for compassion by
criticizing the Legislature's decision to end coverage for 50,000 of the longtime
unemployed as of April 1. There was no mention of these needy people in his
talk Wednesday, and they will be off the rolls as scheduled. Healey and Kriss
also unveiled Medicaid cuts worth $75.2 million spread across the health care
system. Nursing homes, hospitals, and other providers have already been
squeezed, and health care coverage will surely suffer.
Romney also targeted public health with cuts in programs to
prevent teen pregnancy, prostate cancer, AIDS, and smoking. These will have long-term
consequences for the health of Massachusetts residents.
The state fiscal crisis is a reality, and Romney has to act
quickly to make sure the budget is balanced. Nonetheless, it is reasonable to question his opposition
to a tax increase, if not this year, then next, when the budget shortfall may be
worse. Robert Travaglini, the state Senate president, deserves credit for
raising that possibility.
Romney instead holds out hope that a reorganization of state
agencies will yield major savings. "So many families are so close to the edge that a tax increase
could push them over," Romney said Wednesday.
Still, taxpayers need to remember that the state income tax
rate of 5.3 percent is low by the standards of the past 20 years. It was 6.25 percent during the
early 1990s, and that had little impact on a recovery from a recession far more
severe than today's slump. The Legislature needs to consider whether cuts
don't carry their own costs and whether reorganization can substitute for
adequate spending on essential services.
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The Boston Herald
Friday, January 31, 2003
A Boston Herald editorial
Local officials have no cause to cry wolf
The Romney administration yesterday rolled out the details
of its plan to close a potential $650 million gap in this year's budget. As expected, the plan
includes a $114 million cut in local aid to cities and towns, which budget chief
Eric Kriss points out amounts to each community receiving a .7 percent
reduction on average.
No doubt, the airwaves and halls of the State House will be
replete with mayors and selectmen declaring a Main Street Armageddon and announcing layoffs of
teachers and firefighters, and library closings. Kriss understatedly called any
claim that the world is coming to an end as a result of the administration's
budget plan, "simply not credible." And they're not.
Yes, the local aid cuts will have to be absorbed a little
more than halfway through the fiscal year, but that means essentially doubling their impact, which
still would amount to an average cut of only 1.5 percent. Kriss also points out
that most communities have reserves sufficient to cover the entire amount of
the cut. In other words, they can dip into their community's savings account
instead of cutting spending (how many of us have done that when we're short
at the end of the month, instead of giving up that babysitter and night out, wise
move or not?)
The governor's number-crunchers also point out that unlike
the state, which is reliant on income taxes, municipalities have a stable tax base (you still have to
pay your property taxes, even if your spouse was laid off), while state revenues
have dropped dramatically. The state's local aid largesse has also seen state aid
to communities grow by an average of 7.5 percent annually over the last 10
years, from a total of $2.5 billion in 1993 to $5.1 billion this year.
With cooperation from the Legislature, help is also on the
way for those communities seeking relief from costly state mandates and regulation. After
two weeks of jawboning with local officials, Lt. Gov. Kerry Healey's municipal
relief package includes proposals to eliminate civil service, except for police and
fire personnel, cap contributions to municipal employees' health insurance at 75
percent, down from 90 percent, and a range of public bidding and construction
reforms. Repealing the filed sub-bid law and exempting small projects from
prevailing wage requirements should give communities needed flexibility and
cost-efficiency.
Healey noted that the relief package could expand as more
ideas are solicited. One the administration should consider is banning project labor agreements,
requiring union labor on local school projects, which a recent Beacon Hill
Institute report found added an average of 17 percent or $4 million to
the cost of building a school.
The Legislature should act quickly to give the communities
these tools to stretch limited funds now. And mayors who have sacrificed efficiency to
appease organized labor should take advantage of them. Declaring Armageddon
is a lot easier than the hard work of managing to a tighter bottom line. But no
one said this was going to be easy.
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The Boston Globe
Friday, January 31, 2003
Tax hikes won't fly -- not yet
By Scot Lehigh
Hey, you dispirited Democrats reaching for that fifth of 150
proof Old Revenue Raiser to beat back the bitter bile of budget-cutting: Stop that tax tippling. Put
that bottle away. Go on another binge and all you'll see is a long parade of
in-the-pink Republican elephants. That's a warning coming from an unlikely
quarter this week: Philip Johnston, chairman of the Democratic State Committee and a USDA-certified liberal.
"We should not raise taxes," says Johnston. "The voters
voted. They supported Mitt Romney, and they almost passed Question 1," the ballot measure to
eliminate the state income tax.
Johnston's admonition comes at a time when the Senate
president, Robert Travaglini, has declared himself ready to lead the charge of the tax brigade and
when House Ways and Means chairman John Rogers has said that taxes should
be part of the budget solution. All that tax talk, which comes before Governor
Romney has even finished his initial assault on the state's deficit, is the wrong
approach, says Johnston.
"Let's say the Legislature passes a tax bill and Romney
vetoes it," Johnston said. "I don't think we will get the votes to override, so it will just look like,
'Here come the Democrats raising taxes again.'" Instead, Johnston says, his
party needs to cede Romney center stage.
"The voters apparently believed Mitt Romney when he said he
could produce this miracle," the party chief says. "If he can't do it, it will be obvious to the
public that he can't, so let's not rescue him by raising taxes."
Now, to fully comprehend Johnston's mindset, you have to
step into the political time machine and return to one of his formative experiences: the first
Dukakis administration, back when Phil was a young state representative.
In 1974, Michael Dukakis ran on a firm no-new-taxes pledge.
But in 1975, with the budget gap growing worse, the new governor was forced to renege on his
commitment. Before they would pass a tax package, however, legislative
leaders demanded that Dukakis go on statewide TV, acknowledge his mistake,
and announce that new taxes were needed after all.
Johnston, who believes 2003 is very similar to 1975, is just
as clearly salivating at the thought that Romney may eventually have to eat some crow. "The
lesson from 1975 is that these no-new-tax pledges are foolish," he says. So far,
however, the Romney camp thinks the better analogy is not 1975, but 1991.
Back in William Weld's first year in office, a large budgetary hole also loomed.
The mayors bewailed any reductions in local aid while social service advocates
offered dire predictions about the effects of budget cuts. Undeterred, Weld
insisted on keeping spending at a level existing taxes would support. That
meant an actual overall budget cut of 1.5 percent. Still, the effects stopped well
short of the hyperbolic predictions of disaster.
Who's right? It's still too early to tell. Back in 1991 the
state had already had two large tax hikes in the preceding years. This time around there has been
only one, and the net effect of last year's package was to recoup revenue lost
when voters approved a tax cut at the ballot in 2000. Further, the Massachusetts Taxpayers Foundation says that staying within
existing revenues in the next budget will mean a larger overall cut than the one Weld
imposed.
If Romney is forced to break his no-new-taxes commitment,
the new governor's political standing will surely suffer. (Dukakis was beaten in the
Democratic primary in his 1978 bid for reelection.) If, on the other hand,
Romney manages to solve the fiscal crisis without a widespread feeling that he
has devastated core state services, then his stature will only grow.
Either way, however, Johnston is right that the Democrats
shouldn't take a tax-first approach. Rather, they should join Romney in a concerted effort to
scrutinize all state spending to cut what can be cut, to pare back that which isn't
central -- and to snip the surly bonds of special-interest benefits.
Actually, they should have done far more by way of reform
before raising taxes last year. Why didn't they? "There is a limit to how many politically difficult
decisions any legislative body will make in a particular term, particularly
with an election season looming," House Speaker Thomas Finneran said in a recent
interview.
That's laudably honest. But only when such an effort at
savings, consolidation, and reform has been convincingly made will it be time for anyone to talk taxes
again.
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The Boston Herald
Friday, January 31, 2003
Romney under fire after slashing $343M
by Elisabeth J. Beardsley
Gov. Mitt Romney mowed a $343 million swath through the
red-ink-soaked state government yesterday with deep cuts to education, health care and public
safety, sparking accusations of broken campaign promises and heightened
demands for new tax hikes.
Rolling out the cuts, including $114 million in direct aid
to cities and towns, along with $4.8 million in fee hikes and pink slips for 125 state workers,
Administration and Finance Secretary Eric Kriss brushed off the storm of
criticism and claimed that "99.9 percent of state government remains untouched."
"These emergency actions do not cut into the bone and muscle
of government," Kriss said. "None of the ... reductions compromise the core mission of
government." The cuts aim to close most of a $650 million deficit in the current
year - combined with a $143 million package of further cuts Romney put
before the Legislature. The balance of the gap would be covered with about $2 million
in fee hikes and reserve funds to be tapped later in the year.
The governor spent much of the day cloistered from the
public - emerging in the evening to explain his actions at a "town meeting" before a mostly friendly
audience in Leominster under a huge banner that read, "Pennies on the dollar -
For our future."
While acknowledging that he wielded the budget ax against
programs that are part of government's "core mission," Romney denied that he violated his
campaign pledge to balance the budget without new taxes or cuts to essential
services.
"It doesn't mean that all the budget line items related to
those core missions will be saved from scrutiny," Romney said. "When you don't have the money in
the bank to pay the checks, you have no choice but to cut back."
But with $133 million in cuts to health and human services,
education hit for $25 million, and $5.8 million slashed from public safety, even fiscal watchdogs
who typically side with the conservative governor concluded that essential
services had been shredded.
"These cuts have a direct impact on the basic services
provided by state government," said Massachusetts Taxpayers Foundation President Michael
Widmer.
The highest-profile cuts unleashed yesterday fell on the
state Medicaid program, a $6 billion account that provides health care to nearly 1 million of the
poorest citizens.
Romney slashed $75 million from the Medicaid MassHealth
program and asked lawmakers to cut another $39 million, piling on the pain in a program where
50,000 people will lose health care on April 1.
Kriss said the new round of Medicaid cuts would impose new
health care co-payments on welfare recipients and patients who use psychiatric day
treatment and post-emergency detoxification services.
Romney also asked lawmakers to prevent new MassHealth
enrollments by people considered above the poverty level.
MassHealth recipients say they can't afford to be squeezed
anymore.
Dorchester resident Rita Yankowski, 64, said she's scrambling to pay for foot
braces for her 34-year-old daughter, Ann, who has cerebral palsy and recently
lost her coverage.
"She needs to walk," Yankowski said. "Oh my God, (Romney)
should have looked elsewhere - they should all have a cut themselves."
Romney also cut $10 million by unilaterally freezing
enrollments in the state's Prescription Advantage program, which provides cheap prescription drugs to
cash-strapped seniors.
Kriss described the MassHealth cuts as "relatively minor"
and said the reductions could be absorbed with better management. "The service level itself
will not be impacted," he said.
While Romney didn't touch the $3.5 billion Chapter 70
education reform account, he cut deeply into other school programs, slicing $10 million from
school readiness grants, $3.1 million from breakfast programs, and $11.8
million from early literacy.
Romney also hit the University of Massachusetts and the
state and community colleges for $15.9 million.
"All of the work that we've done under education reform
starts to slide away," said Massachusetts Teachers Association President Catherine Boudreau.
In public safety, Romney suspended the incoming state police
class to save $2.9 million - after a year of efforts to recruit more troopers to fight terrorism.
Romney also axed a favorite program of lawmakers, special state police patrols
at beaches and shopping malls.
The ax also fell on such previously protected areas as the
Department of Mental Retardation, where Romney cut $4.6 million from residential services,
day programs, family support and institutions.
The governor also levied new DMR fees, forcing clients to
pony up $25 a month for transportation and $25 a month for day services.
The cuts alone will yank direct services from at least 700
people, and possibly harm the quality of care for the 1,000 people who live in institutions, said ARC
Massachusetts director Leo Sarkissian.
"We've got a community service system that really is getting
slammed," Sarkissian said.
The single-biggest cut was Romney's $114 million reduction
in local aid to cities and towns - a 5 percent cut.
Massachusetts Municipal Association President Michael
McGlynn objected to Romney's plan to cut local aid money from Lottery aid and so-called additional
assistance accounts - targets that will cause the most pain in poor urban areas.
"What the governor tried to do through his spokespeople was
to lull everybody into a false sense of security, take advantage of our good nature, and then bring
out the hatchet and start an attack upon cities," said McGlynn, the Medford
mayor.
Kriss countered that cities and towns are sitting on roughly
$700 million in local reserve accounts - and that 214 communities have enough cash to offset the
local aid cut.
The impact of the cuts left local leaders calling for tax
hikes. McGlynn said raising the income tax to 5.6 percent would raise $450 million a year.
Elizabeth W. Crowley contributed to this report.
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The Boston Herald
Friday, January 31, 2003
Wails of despair and anger rose from city halls yesterday as
Gov. Mitt Romney's $114 million in local aid cuts hit home - setting off plans for layoffs
and a massive scale-back of basic municipal services.
Mayors whose cities took the hardest hits derided the
governor for breaking his campaign promise not to hurt the "core mission" of government to balance
the budget.
"My core mission has been destroyed," said Mayor Dorothy
Kelly Gay of Somerville, which took the single largest proportionate cut, at nearly $3 million.
"I'm looking at every way to squeeze this existing budget before I pink slip
anybody - this is a terrible economy to give people pink slips."
Standing with Somerville as the hardest hit were urban
centers like Boston, Revere, Medford and Malden along with middle class and rural areas like
Spencer, Athol, Amherst and Cheshire.
Gay said Somerville has a $1 million reserve fund she must
maintain for emergencies. She already has raised fees, fines and taxes and pushed through
an early retirement program to meet a $2.2 million deficit last August.
"I had the political courage to do that, but the governor
doesn't seem to have political courage," Gay said. "He ran (for office) saying he would preserve
essential services."
Boston Mayor Thomas M. Menino called his $24 million cut
"devastating" and claimed education would be hurt, despite Romney's vow to protect it.
The spending cuts, Menino said, "represent the second part
of a double whammy" inflicted on cities this fiscal year by Romney and former acting Gov.
Jane M. Swift.
Menino urged the Legislature to pass his package of local
option tax hikes, such as the meals tax.
Boston's budget director, Lisa Signori, said the city's $60
million to $70 million of reserve "free cash" should not be depleted to fill this year's deficit.
But the anger wasn't universally shared. Lawrence Mayor
Michael Sullivan, a Republican with a private business background, said he is taking his $1.9
million cut in stride and suggested that mayors stop complaining.
"We've been downsizing for the last eight months, merging
departments, collecting back taxes and back water bills - what cities should be doing,"
Sullivan said.
"Isn't it a shame when a real number and a real strategy on
a real shortfall stirs up all this emotion? Raising taxes doesn't buy your way out of this. We need to
get together as mayors and elected officials and do whatever we can to get this
economy going again."
Sullivan said his city's $9 million reserves will help
absorb the cut.
But Lynn Mayor Edward J. (Chip) Clancy Jr. said his reserve
fund is empty and his only solution to Lynn's $2.5 million cut is "bodies and blood."
"You can't make cuts to this degree without severe reductions in essential
services," Clancy said. "If you want to say we'll cut back on police and fire then
say so. (Romney) knows it."
An earlier $900,000 cut in Lynn forced the closing of two
nursing homes, Clancy said.
"There's no cartilage left in our budget - it's all bone,"
he said.
Medford Mayor Michael J. McGlynn called his $1.4 million cut
a "nightmare" and accused Romney of making a "direct attack on the cities."
"The governor has to understand there's a big difference
between a board room and being a public servant," McGlynn said. "We're there not to slash a
division but to educate children and provide a safe environment for our
families."
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The Boston Herald
Friday, January 31, 2003
Dems behind Mitt, way, way behind him
by Thomas Keane Jr.
I spent Wednesday night breathlessly waiting for Gov. Mitt
Romney, Speaker Tom Finneran and Senate President Robert Travaglini to announce whether
they'd be joining Boston's city councilors in their fast against the Iraq war.
Would they, like some councilors, be pushing to have the commonwealth take
on George Bush, casting their lot with poor, beleaguered Saddam?
Disappointingly, no. Instead the three spent their 15
minutes of fame (nine for Romney, about six for the two legislators) talking about budgets, spending and
taxes. Unlike the City Council, apparently, they have better things to do.
This was the public's first opportunity to see Massachusetts' three most
powerful men in action. All looked a bit like animals caught in the headlights
(Romney, a deer; Travaglini, a koala; Finneran, a ferret). Moreover, the timing
was terrible: They had to follow on the heels of Bush's masterful delivery of the
State of the Union from the night before. It was kind of like watching a
community theater production after having just seen the play on Broadway.
Romney - the best of the three - was oddly positioned, his
body facing to one side while his head was turned to the camera, kind of like the setup at Sears
when you go to do the family portrait. Travaglini, fresh off the streets of East
Boston and on to the statewide stage, could have used a better shave and a
voice with some modulation.
Finneran, bouncing and weaving on camera like a Nomar
bobblehead, has an ability to sound sarcastic no matter what he says. "Governor Romney's election
is not to be trivialized," was my favorite line. Until Finneran voiced that
thought, I had been unaware anyone had been trivializing the election. So who
is? Well, obviously, Finneran. He was using a denial to raise the notion that
Romney should, in fact, be thought of as trivial.
Still, there was substance to these back-to-back speeches,
and it boiled down to this: The state's budget shortfall is really bad. Romney is willing to take the hits
for fixing it. And the Legislature, at least in the short term, will be happy
to let him take those hits.
In other words, Mitt: We're behind ya. Way behind ya.
Here's the plan. The deficit for this fiscal year (which
ends June 30) is roughly $450 million to $650 million. Romney will make cuts totaling $448 million
(including one that has mayors and town managers going ballistic, a $114
million reduction in local aid). If the budget gap is higher than $448
million - as Romney fears - then the rest will come out of the state's reserve funds.
That may sound difficult but comparatively speaking, it's
easy. Travaglini and Finneran both made it clear they're not stopping Romney on this round.
But with a projected shortfall of $3 billion, next year will
be a different case.
Romney presents his budget in a month, and Travaglini and
Finneran were sounding notes of caution.
Finneran, who despite his odd mannerisms and mocking
undercurrents is clearly the most familiar with the challenges of a tough budget, laid down his
gauntlet: education, public safety and health care. Those are his big three - the
"essential services" that should be held sacrosanct.
Travaglini raised the prospect of new taxes. It was the only
real clash of the evening. Romney earlier had forcefully rejected higher taxes. Travaglini agreed
there would be no new taxes this fiscal year. That's an easy enough promise -
only five months remain. And next year? Only as a "last resort."
Uh oh. Shannon O'Brien used the same formulation in her run
for governor and voters understood the term "last resort" to mean "probably."
What should "last resort" really mean?
If Massachusetts raises taxes and the Quinn Bill (which
boosts cops' salaries by millions in exchange for taking bogus classes) is still around, then taxes were
not raised as a "last resort."
If we raise taxes and the Pacheco Bill (which prevents the
government from using competition to deliver services more cheaply) is still law, taxes were not
raised as a "last resort."
If we raise taxes and the Community Preservation Act (which
gives state money to towns so they can stop land from being developed for housing) is still
funded, then taxes were not raised as a "last resort."
The list can go on and on.
So, bottom line, the message is this: The next five months
are Romney's to do with as he pleases. After that, it may very well be a free-for-all. Romney seems
serious about "restructuring" government but, ultimately, that means getting
rid of lots of programs that have lots of support. The measure of the Legislature will not be Wednesday evening's words of
cooperation. Rather, it will be its willingness to hold to Finneran's essentials while staring down the
special interests knocking at its door.
