Dede Feldman
As we head into the special session, projections of our state’s budget shortfall get worse and worse. And the specter of massive cuts — or even a few tax increases — looms larger every day. Letters and e-mails are flying about who’s going to get cut.
At one recent town hall in my district, a constituent came up to me afterwards in tears because I had told the crowd that the State Coverage Initiative (SCI), one of the state’s few affordable health insurance programs, might get cut.
“I have cancer,” she said, “and I’m on the program.”
Her remarks got me to thinking how high the stakes were in this economic downturn and how easy it is to forget some basic principles. So here they are, my guidelines for making these hard budget decisions.
• Don’t make cuts that cause people to die. Yes, some cuts in funding will have that dire of an effect. One AIDS patient, for example, left a message on my answering machine asking me to think very carefully about cutting Medicaid funding for the AIDS waiver, which now goes mostly to medications and counseling. His life, literally, hangs in the balance.
The AIDS & HIV-positive patients are not alone. There are thousands of medically fragile children, seniors in nursing homes with life threatening conditions, cancer patients and others served by the Medicaid program, which will need $300 million just to stay afloat next year.
• Salary reductions, if there are to be any, should be done on a sliding scale, not across the board. What sense does it make to cut the meager salary of an educational aide who makes $8 per hour the same percentage as an administrator who makes $100 an hour? Yet, this may be the effect of across-the-board cuts, particularly if it is the administrators who decide how to implement reductions.
• Don’t cut off your nose to spite your face. As much as some folks resent federal funding, it is a fact of life that our Medicaid program gets four federal dollars for every state general fund dollar that we put into health care services for almost 500,000 low-income New Mexicans. Cuts to the program are magnified four-fold, and that doesn’t even count the major economic role that the health care sector plays here, especially in small communities.
At a recent committee meeting we were told by one economist that, as a result of the “multiplier” effect,” $300 million taken out of this program means a loss of about 15,000 jobs — in hospitals, clinics, medical offices and associated areas. Ironically, the health-care sector has been one of the fastest growing ones here in the past decade, with a gain of about 30,000 jobs until the recession hit.
• Those who profit from the recession must do their share — and pay up. As is often the case in recessions, the pain is not equally shared. As small businesses struggle to stay afloat, mortgages are foreclosed and bankruptcies escalate, the parking lots at Wal-Mart and other discount stores have filled up. Often these out-of-state corporations have eluded taxation because of a loophole in our tax code called “combined reporting.” These out-of-state companies are not paying their fair share.
Feldman, a Democratic state senator from Albuquerque, chairs the Senate Public Affairs Committee.