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Texas Deprioritizing ADAP, Texas Committee Votes to Reduce Health Cuts
Deliberation about what to cut - and whom to save - ended with a vote to restore $4.5 billion to state health agencies at a Senate Health and Human Services subcommittee hearing this morning. The issue now goes to the full Senate Finance Committee, which will debate whether to add the funds back into the Senate appropriations bill.
State Sen. Jane Nelson, R-Flower Mound, says this morning's vote "represents our best effort to address our top needs first," and will restore 505 full-time positions and funding for programs like Early Childhood Intervention and foster care. It will also, she says, significantly reduce cuts to reimbursement rates for physicians, hospitals and nursing homes.
But some senators argue that funding should be restored for more services. "Certainly the $4.5 billion restoration is a positive step, but we all know that we need more," says State Sen. John Whitmire, D-Houston, who voted against moving the measure to the full Finance Committee. "How can I vote for something that I know is going to create pain [and] cut basic services for thousands of Texans, when I know there's still an option of ... the Rainy Day Fund that's across the street in the bank?"
Based on the health agencies' requests, the Legislative Budget Board presented two priorities for each agency to the committee. The first priority for each agency was adopted, but none of the agencies' second priorities got funding from the subcommittee's vote. The state agencies affected by today's vote include State Health Services, the Department of Family and Protective Services, the Department of Aging and Disability Services and the Department of Assistive and Rehabilitative Services.
The lack of funding for secondary priorities had some senators concerned. "When we vote on an item like this, we are basically making a decision about who lives and who dies," says state Sen. Judith Zaffirini, D-Laredo. She was speaking about $19.2 million in funding requested for HIV medication by the Department of State Health Services. Because the LBB presented the request as secondary priority, it did not get its funding in the vote today.
The HIV medication program only serves Texans who are uninsured and have an income of less than $30,000. It costs the agency $6,000 to $7,000 per person for medication, but the state can buy medication for Texas recipients cheaply relative to other providers, says David Lakey, the commissioner of State Health Services. "They are not able to fight infectious diseases and the natural progression, without any medications, would be that they would die," he says.
Lakey told senators that counseling, awareness programs and other services that protect uninfected Texans would also be reduced if more funding is not restored. The state needs the money to, for example, track down partners of infected people and counsel them to help stop the spread of the disease.
"We're not making these cuts from a philosophical desire to cut government," says Sen. Bob Deuell, R-Greenville, who voted to restore the funding. Deuell says he has received support from his conservative Republican district to raise revenue by increasing sales tax, gas taxes, and tapping into the Rainy Day Fund, but some cuts are inevitable. "We're constitutionally mandated to live within our means," he says.
Senate considers cuts in HIV treatment for poor
By CHRIS TOMLINSON, The Associated Press March 24, 2011, 1:58PM ET
A Texas Senate subcommittee approved a proposal Thursday that would cut a program that supplies HIV drugs to 14,000 poor people, even after adding billions of dollars for health and human services.
Lawmakers voted to spend an additional $4.5 billion on state-supplied health services, but the HIV program was not a top priority. Where the state would find the additional funding was also not addressed.
Texas is facing a $24 billion budget shortfall to maintain current services. The chair of the finance subcommittee, state Sen. Jane Nelson, told budget writers to put their priorities into three categories, with priority one being the most important.
"In light of our current fiscal constraints, what you have before you today are the recommendations to our full finance committee to add $4.5 billion of priority one items," Nelson explained.
But when the HIV drug program showed up as a priority two item, Democratic State Sen. Judith Zaffirini asked the Department of State Health Services commissioner, Dr. David Lakey, what would happen if the patients did not get their medication.
He replied: "The natural progression, without any medications, would be that they die."
"And this is in priority two, which is really a wish list?" Zaffirini asked. "It is my belief that when we vote on a priority like this we are basically making a decision regarding who lives and who dies."
Nelson had Lakey explain that one-time-only funding from the federal government paid for the $19.2 million program in the last budget cycle, and now that funding is gone. The program currently provides $6,700 worth of HIV drugs to 14,000 people who don't have insurance and make less than $30,000 a year, Lakey said.
"I simply cannot vote for this proposal. I believe it is wise to add $4.5 billion, but that is not enough," Zaffirini said. "And I doubt items in priority two will be funded at this time."
Even Republicans who voted to recommend the bill to the full Senate Finance Committee said they didn't like the proposal.
"It's going to be real hard for me to support the budget out of full committee if we only put the $4.5 billion back," state Sen. Kevin Eltife, R-Tyler. "There are too many Texans that need our help that will be hurt if we only do the $4.5 billion."
Also Thursday, the non-partisan Legislative Budget Board released data that showed the state would lose 335,000 jobs if the current budget proposal in the House became law. The board said the budget would eliminate 188,787 state jobs by the end of 2013 and private companies would eliminate 146,457 jobs under the current House budget proposal.
"The voters did not elect us to eliminate hundreds of thousands of jobs," state Rep. Mike Villarreal, D-San Antonio, said in a statement. "We can't grow the Texas economy with a budget that destroys jobs, hurts neighborhood schools, and makes college more expensive."
Both houses of the Legislature are drafting separate versions of the budget, and each cuts spending in different ways. Once each chamber passes a version, lawmakers will meet in a conference committee to come up with a final draft. The current House version calls for no new revenues and avoids spending the $6 billion balance remaining in the state's Rainy Day Fund. The Senate is looking for $5 billion in new revenues and appears ready to tap the fund.
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