Budget cuts, the cumulative impact

[Cross Posted from SFGate: http://www.sfgate.com/cgi-bin/blogs/rchoi/detail?entry_id=89117]

A few weeks after the release of Governor Brown’s January budget I attended a Senate Subcommittee hearing on Health and Human Services in Sacramento. The Governor’s proposal included increases in co-pays and premiums for beneficiaries of Healthy Families (SCHIP) and Medi-Cal as well as taking $1 billion dollars from First 5, a vital program for young children in my clinic and many other communities across the state. I was there to describe the impact these program cuts would have on children and families.

While I was prepared to give my testimony I was completely unprepared for the heartbreaking testimony given by others who pleaded with the Committee members to spare their programs. The proceeding four hours were some of the most difficult I had ever experienced. As the Senators worked through pages of proposed cuts, lines of foster mothers, chronically ill seniors, advocates, and agency representatives formed to describe the harsh reality of the cuts to lives of real people.

More than once did someone say that people were going to die from these cuts. To be fair, the Senators were sympathetic but only responded with “our hands our tied” rhetoric. The entire morning was brought into focus by one comment: we must recognize the “cumulative impact” these cuts will have for some populations.

As a community health center physician, the communities I take care of are the first to be laid off when a business has to downsize. They are the least able to accommodate a rise in food prices or a hike in college tuition. They are the least likely to have a connection to a legislator or official who can help. They are also more likely to be sick and on multiple medications. They are among the ones who need the threatened services the most, particularly in difficult times such as these.

But it is not just them. Many formally middle class and upper class families are getting pulled down as well. In a private clinic where I work part-time, I see parents who lost a job bringing in their children for one last check up before their health insurance coverage terminates. The next day in my community health center, I will see new patients who formally had private health insurance coming in for urgent problems. In fact, the influx of the newly uninsured is stretching my health center’s fiscal limits.

Unfortunately, $6 billion in proposed cuts to health and human services, including the ones mentioned above, passed in March. Now further hobbled, families are at the breaking point.

The state Republican proposal released last week continues the pile on with further reductions to mental health and early child development programs.

The Governor’s May revised budget released today revealed that the state is unexpectedly bringing in $6.6 billion dollars in revenue. But our problems are not yet solved if you count the $10 billion deficit that remains. Critical health services will continue to be threatened until the budget is resolved with revenue sources.

So what if legislators are unable to agree on tax extensions?

A New York Times Sunday Magazine feature article about Governor Brown quotes him as saying: “You have to keep cutting to the point where people say they want to increase their contribution.”

As intractable as the situation appears, this solution is wrong headed and completely ineffective. A cuts only agenda will grind down the growing numbers of people who are bearing the brunt of this recession past their ability to rebound. They will have nothing left to contribute.

Recognizing the cumulative impact of further cuts on California’s families, we must urge our legislators to pass a final budget that includes sensible tax extensions and revenue sources.



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