The state health department has drafted a $480 million list of potential program cuts that, if enacted, would deprive thousands of children of free health insurance coverage and shutter four mental health facilities, and could force women to pay for their own laboratory tests after rapes, according to documents obtained yesterday by The Sun.
"It basically tells people if you are sick, leave the state," said Sen.
Paula C. Hollinger, a nurse and chairwoman of the Senate Education, Health and
Environmental Affairs Committee. "It's like taking health care off the
respirator and saying goodbye."
The Department of Health and Mental Hygiene developed the list in response
to Gov. Robert L. Ehrlich Jr.'s request that agencies devise ways to cut
spending by 12 percent.
The elimination of programs, the governor has said, is the only way to
close a projected $800 million budget deficit without raising taxes.
The governor and his aides said they had hoped to keep the proposals
confidential, issuing a gag order last month that prohibits agencies from
sharing budget requests with legislative analysts. Yesterday's leak violated
"You hope that everyone within an administration would be on the team,"
state Budget Secretary James C. "Chip" DiPaula Jr. said. "There is a question
now that somebody might not be."
Because an improving economy could make many cuts unnecessary, Ehrlich
staffers said they hoped to avoid the kind of outcry that followed the leak of
the health department's budget planning document yesterday, as lawmakers and
health advocates digested the scope and specificity of the reductions under
"These cuts are just immense and are devastating to public health, not just
in Baltimore but in the entire state," said Dr. Peter L. Beilenson, the
Baltimore health commissioner.
The proposal would eliminate health programs for at least one in six city
residents, he said.
DiPaula would not comment on the list, saying he has yet to receive
submissions from the health department.
Ehrlich is months away from making final budget decisions before he submits
his next spending plan in January, DiPaula said.
"It's unofficial, if not fake," he said. "How can [The Sun] have something
that we don't have?"
But outgoing state Health Secretary Nelson J. Sabatini acknowledged that he
asked his staff to identify programs not mandated by federal or state law that
could be eliminated.
To meet Ehrlich's request for a 12 percent cut, the health department has
to identify about $430 million in programs, $50 million less than what the
draft list contains, he said. The department's $3 billion-plus in general
state funds is supplemented by about $2.5 billion in federal funds.
"[DiPaula] has repeatedly said you can't get to the level of reductions
that we are going to be facing by nibbling at the margins anymore," Sabatini
Last spring, Ehrlich launched a review of agency spending by asking
managers to complete a "strategic budgeting guide," identifying
less-than-critical programs in the state's $24 billion budget that could be
The health department proposals include eliminating a popular health
insurance program for children and pregnant women to save $47 million, and
abolishing health care for medically needy Medicaid recipients to save $115
Another proposal would curtail a sexual assault evidence collection
reimbursement program, which a department budget planning document warns
"could lead to victims being billed, thereby creating a barrier to care."
"Can you imagine a rape victim being charged for evidence collection?"
Beilenson said. "I cannot believe anybody would even remotely consider such an
inhumane budget cut."
Md. ponders deep health care cuts
Leaked after gag order, a draft trims $480 million
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