HELENA - Healthy Montana Kids, the voter-approved government health insurance program for children, had its budget trimmed Friday, as Republican lawmakers voted to shift some of its funds toward another health program.
On a series of party-line votes with Republicans in favor, the Joint Appropriations Subcommittee on Health and Human Services whacked about $18 million in spending authority from HMK for the next two years.
In turn, those funds were funneled into Medicaid, the state-federal program that pays medical bills for the poor.
"None of the choices that we're making in the last couple of weeks have been pleasant," said Rep. John Esp, R-Big Timber, a panel member who led the move to transfer the funds. "We're trying to figure out how to preserve the core services for the poor in the Medicaid area."
Friday's vote is a recommendation from the House-Senate budget panel that will be forwarded to the full House Appropriations Committee next month. However, it will take a positive vote by Republicans to undo their action.
While the vote reduces HMK budget authority, it doesn't cut people currently on the program. Its effects would be felt in the next two years only if the program adds a lot more people in the upper levels of its income eligibility.
HMK provides free health coverage for children in families earning up to 250 percent of the federal poverty level, or nearly $56,000 a year for a family of four.
Since voters approved HMK in November 2008, about 18,000 children have been added to both Medicaid and the Childrens Health Insurance Program, the two programs that make up HMK. Supporters of the plan have said as many as 30,000 additional kids are eligible.
Esp's motion used the savings from HMK to help pay for increased Medicaid costs that were revealed earlier this week.
The Schweitzer administration said Monday that changes in federal rules would lead to an additional $22.4 million in state Medicaid costs over the next two years.
The changes on Friday shifted money from HMK and elsewhere to cover about $14 million of those costs.
Sen. Mary Caferro, D-Helena, who voted against the cuts to HMK funding authority, said the move isn't necessary. The budget contains $25 million in federal funding from last year that was supposed to go to Medicaid expenses and could cover the Medicaid costs, but instead is being used to pad the state treasury's surplus, she said.
"I just think it's a shame," she said. "We sit here and we talk about these millions of dollars, and really, what it means, is less health care for children."
Caferro also noted that the cut in HMK funding authority also seeks to remove a requirement that the state enact something called "presumptive eligibility," a program designed to streamline the signing up of eligible kids for the program.
The state began putting presumptive eligibility in place late last year.
"That (removal) is not a good thing," Caferro said. "That's a foolish move, because it really saves a lot of cost-shifting (to other, paying patients) in the hospitals. Almost every other state does it."
Missoulian State Bureau reporter Mike Dennison can be reached at 1-800-525-4920 or at firstname.lastname@example.org.