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.