Newspaper article Charleston Gazette Mail

Budget Cuts Can Bring More Expenses

Newspaper article Charleston Gazette Mail

Budget Cuts Can Bring More Expenses

Article excerpt

As legislators resume their work on the state budget, lets hope they realize when a cut in spending turns out to be an increase in spending. That might seem crazy, but it easily could happen if budget balancers are not careful. And if it happens, taxpayers could end up paying much more to address behavioral health services than they do now, while harming the people who need those services.

Community behavioral health services were established in our state as a tool to reduce the excessive costs coming from the state mental health hospitals in the 1970s.

Although some legislators are reluctant to do so, they must consider increasing revenues, because cuts alone wont be enough to cover a few hundred million dollars in budget shortfall. In particular, an increase in the tobacco tax makes the most sense.

Lets understand how a cut can become an increase. It has happened before in behavioral health services. Many services are covered by Medicaid, which is made up mostly of federal dollars. For every dollar the state spends in the Medicaid program, it gets almost three times as much in matching funds from the federal government. Consequently, when the state cuts $1 out of its spending on Medicaid services, such as those in behavioral health, it results in cutting almost $4 in services delivered.

The state has cut spending on behavioral health services in the past as part of previous budget-balancing efforts. In particular, some community-based services were cut. When individuals were unable to get those services, their behavioral health issues did not go away. When their problems got worse, many required hospitalization in state-run facilities or incarceration in prisons and jails, and those costs are paid using state-only dollars rather than through a favorable federal match.

Thus, unwise budget cuts led to spending increases.

Some who want the state to cut its way out of its budget hole have proposed further cuts in Medicaid-funded programs, such as behavioral health. To be fair, perhaps they havent been involved long enough to have experience with previous cuts and the resultant costs. Nevertheless, their proposed cuts would be shortsighted, especially at this time. …

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