March 30, 2007
A LITTLE LESS ROLLER, A LITTLE MORE STEAM
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Noises Off: Compromise is in the air.
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A cryptic, late-night one-page press release sent out Tuesday signaled that Governor Eliot Spitzer and legislative leaders had worked out a deal on state spending and might meet New York’s April 1 budget deadline.
Since then, legislators and staff have worked around the clock to finish the budget, while reporters and political insiders have compared opinions over the extent to which Spitzer was out-negotiated by his prime political opponent, Senate Majority Leader Joe Bruno.
Sad to say, Thursday’s consensus opinion in the Capitol was that the first-year Governor got rolled by the veteran Senator.
But important aspects of the budget were still being negotiated, and all sides were slow to declare victory – perhaps for fear of tipping their opponents off on priority items and extending the fight even longer.
Few reporters were clear on the extent to which Spitzer was able to embed reform principles into the agreed-upon health care restorations.
And health advocates were applauding Spitzer and the Assembly for winning an expansion of the Child Health Plus program to 400 percent of the federal poverty line, getting care to 400,000 uninsured kids.
Still in the fight
Housing Works clients and staff are still fighting for funding in the final budget for 1,100 families with disabled children and parents living with AIDS to get the proper amount of disability benefits.
You can read all the details about “AIDS SSI Invisibility” here. The measure has won strong support from Assembly members, and negotiators for the Senate and for Governor Spitzer appear to be in support as well.
Health care winners and losers
Medicaid Matters New York, the statewide consumer coalition, had this statement on the budget, with this comment:
“It looks like the final budget agreement will take New York a few steps in a new, better direction on health care. We might have taken quite a few more, if powerful lobbyists for hospital associations and 1199/SEIU hadn’t blocked the path.”
Indeed, hospitals, nursing homes and the powerful healthcare workers’ union 1199/SEIU crowed that Bruno got them most of what they needed – restoration of a majority of nursing home cuts and of a significant portion of cuts aimed at hospitals.
Spitzer objected to the spin – he said over half the hospital cuts were achieved, and that the health care budget marked the first significant move towards reform in a decade.
In one important respect, he’s right: Over a quarter-billion dollars in structural funding will be distributed to institutions based on the number of Medicaid beneficiaries they serve. That’s a move in the right direction, and an important first step towards real reform.
But the budget agreement so far does not provide funding for housing subsidies to help implement the Nursing Facility Transition and Diversion waiver, something that would help people who need long-term care services to live independently at home and receive care in non-institutional settings.
And the agreement does not include any significant new investment in community-based primary care, despite universal agreement that strengthening and expanding the primary care infrastructure is critical to meeting the health care needs of all New Yorkers.
Spitzer won modest trims and reforms in Graduate Medical Education funding, and in workforce recruitment and retention programs that have been criticized as political pork.
Nursing homes got restoration of about two-thirds of the cuts Spitzer wanted, along with two full years to make a move towards reimbursement based on the number of Medicaid patients they serve.
And efforts to reform New York’s notorious bad debt and charity care pools (which pay hospitals without regard to their actual policies and practices towards the uninsured) were blocked by a year-long legislative study panel.
A race to the finish
Spitzer, Silver and Bruno said Thursday evening that they’ve got enough of an agreement to pass the budget by Saturday’s midnight deadline.
Budget conference committees were meeting Thursday night - staff will be working a second (and probably eventually a third) night with little or no sleep to finish negotiations and print thousands of pages of budget bills.
Watchdog groups, including the League of Women Voters, Common Cause, NYPIRG and the Citizens Union, criticized the secret negotiations and frantic rush to close that have marked this year’s budget process. We’ll let you know how it all worked out in next week’s Update.