Recent editorials [May 25, May 15] and articles [Metro, May 20, May 14] about the "Medicaid deficit" that was predicted by the D.C. Medicaid director, Paul Offner, make it imperative for me to explain the actions taken by the D.C. Council during the FY '00 budget process.
The D.C. Department of Health, of which the Medical Assistance Administration is a part, submitted a budget request for Medicaid in the amount of $242 million in local funding, which represented a decrease from the $247 million in local dollars budgeted for FY '99. The Office of Budget and Planning subsequently added $19 million in local funding to the Medicaid budget. However, when the D.C. Council asked for an explanation of how the additional $19 million would be spent, it received no satisfactory answer.
In three out of the past four years, the District's Medicaid budget has enjoyed double-digit surpluses. In FY '98, the Medicaid program ended the fiscal year with a surplus of more than $48 million in local dollars, all of which was used to eliminate the accumulated deficit.
Last year, the council's Committee on Human Services, which I chair, reduced the recommended baseline budget of Medicaid by $10 million in local funding. But even with that reduction, the Medicaid surplus was sufficient to fund all FY '99 expenditures for the Children's Health Insurance Program and Healthy Families expansion. As of a week before the Committee on Human Services mark-up, the Medicaid director was anticipating a surplus of $7 million in local funding.
Faced with other pressing health needs in the city, my committee redirected some $13 million to other programs, most of which had been "mistakenly cut" from the budget. The Medicaid director could not persuade the full council, the control board or the mayor to reverse that action. However, during the consensus process, the committee did restore $3.5 million to the Medicaid budget.
When Offner could not persuade policymakers to further increase his budget, he met with hospital officials and threatened to reduce their rates if he did not get a budget increase. Yet in previous years, Offner returned millions in unspent surpluses without increasing anyone's rates. He was able to achieve the surpluses in large part because he already had cut rates to doctors, hospitals, pharmacists and other providers.
I opposed the mayor's budget proposal to expand Medicaid benefits to all uninsured city residents, because the proposal's underlying assumptions were inappropriately analyzed, financing was speculative and inadequate and the potential was there to jeopardize the District's safety net. However, I did support a compromise pilot program to be implemented in FY '00 as well as the formation of a committee of all the stakeholders to jointly implement health care restructuring for the District.
I also increased funding for HIV/AIDS and for substance-abuse programs that have been cut year after year. I put money into the Child and Family Services budget to provide services to children and families in distress and into Maternal and Child Health to further address infant mortality. I added funds to the budget to increase the numbers of inspectors for day care facilities and for group homes for the mentally retarded because these are areas presenting major problems for the District's children, youth and families.
Unsound health care policy jeopardized Greater Southeast Hospital, which is a critical health care provider in my ward. However, I introduced legislation, which the council passed, that enabled the District to make an emergency loan to a hospital in a medically underserved area that is in financial trouble. I waged a successful campaign to protect the health of the District's most needy residents while ensuring that my constituents' tax dollars will be well spent.
-- Sandra C. Allen
represents Ward 8 on the D.C. Council.