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Senate subcommittee votes to restore $4.5 billion to health and human services

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After weeks of painful testimony and work groups, state Sen. Jane Nelson’s Senate Finance subcommittee on Medicaid voted 5-2 to send its final health and human service budget recommendations to full committee this morning.

The subcommittee was originally tasked with finding ways that the Medicaid program could sustain almost $10 billion in cuts. Their task was later expanded to find cost-saving measures in the entire health and human services portion of the budget, known as Article II, which took a $16.1 billion cut total in the Senate draft budget.

Rather than offering cuts, Nelson instead proposed adding $4.5 billion back into health and human services. “After hearing from stakeholders, departments and most importantly the citizens of Texas … this $4.5 billion represents our best efforts,” Nelson said.

The committee instead highlighted places to restore or add funding: fully mental health funding, adding Child Protective Services workers and maintaining current foster care subsidies. The subcommittee also suggested softening the Medicaid provider rate cuts—instead of the proposed 10 percent cuts, under the new recommendations, Medicaid and CHIP physicians would see a 3 percent cut, while other providers like nursing homes would see a 5 percent reduction.

“Certainly the $4.5 billion restoration is a positive step, but we all know that we need more,” said state Sen. John Whitmire, who voted against the recommendations. Whitmire would like to see the Senate spend more of the state’s $9.4 billion Rainy Day fund.  “How can I vote for something that I know is going to create pain for thousands of Texans when I know there’s still an option,” he said.

Lt. Gov. David Dewhurst was concerned about the new recommendations. He said the Senate Finance committee would wait to consider them while members came to agreement.

“Last night … I thought we were on the same page,” he told reporters. “We’re going to hold off for a while and continue to work on it.”

Whitmire said he wouldn’t support the budget recommendations until an additional $2.5 billion, which the subcommittee labeled as a “priority 2,” was also restored.

At this morning’s hearing, Whitmire took particular issue with a recommendation to reduce the free HIV and AIDS retroviral drugs distributed by the Department of State Health Services. Without the Texas HIV Medication Program, 14,000 low income and uninsured Texans with HIV/AIDS will go without medication, which Whitmire noted wouldn’t just affect their treatment but the spread of infection and counseling services. “So conceivably, this would affect many more thousands,” he said.

State Sen. Judith Zaffirini, D-Laredo, showed concern about the proposed reduction of community-based and independent living services administered by the Department of Aging and Disabilities Services. DADS commissioner Chris Traylor told the committee that nearly everyone on one of the many waiver programs would see some sort of reduction of services, but emergency response, nursing services and meal delivery services would not be touched. Zaffirini also voted against the recommendations.

“It’s wise to add $4.5 billion but that’s not enough,” she said. “If we can’t (restore more funding) now, we can’t do in full committee.”

State Sens. Juan Hinojosa, D-McAllen, Bob Deuell, R-Greenville, and Kevin Eltife, R-Tyler, voted to move the recommendations forward but acknowledged that more work needs to be done.

“There are too many Texans that need our help that will be hurt if we only do the $4.5 billion,” Eltife said. “I want it to be clear that (voting for the recommendations) doesn’t mean I support the budget.”