MONEY FOR HEALTH

Gov. King kept his word and more in restoring funds to state health care programs now that the budget shortfall does not look as dismal as expected. But the earlier proposed cuts raised several issues that the new revenues merely paper over and do nothing for programs under the Fund for a Healthy Maine, created by the tobacco settlement three years ago.

The governor had listed health programs, mostly those matched by federal Medicaid dollars, that would be the first to return if the revenue forecast brightened. When it did last month, he restored money there and also proposed returning money to related health programs for the mentally ill and mentally retarded and for the poor who otherwise would not qualify for Medicaid. The restored funds allowed the providers of these essential services to avoid steep cuts in programs. The Legislature should similarly support restoring the funds.

The possibility during the last couple of months that money for these programs might not be available, however, brought forward questions that in better times no one wants to ask. For instance, nonprofits providing care to the mentally ill observed that the Department of Behavioral Services is increasingly providing the same services but wonder whether the state is as cost-effective. Medicaid continues to expand its reach, but some physicians properly wondered when the public health plan is going to begin to reimburse their costs fairly. And both the governor and House Republicans have pointed out that Maine’s Medicaid program is considerably more extensive than those in most states and have raised doubts whether taxpayers can continue to afford the state share.

And there is the Fund for a Healthy Maine. The tobacco settlement will send Maine between $55 million and $60 million a year for the next two decades. It sounded like a lot of money when it was first promised and the new programs the state decided to fund with it sounded like a solid, compassionate attempts to reduce Maine’s tobacco addiction and support healthier living. Those programs still sound good, only now the money doesn’t seem so substantial, especially when a good chunk of it goes to other worthwhile Medicaid programs.

The Legislature’s Appropriations Committee currently is going through the fund line by line to figure out how $13 million in proposed cuts will affect the ability of programs to operate. That’s a necessary step for the upcoming budget. But lawmakers also have a more basic question: Does Maine want a fund dedicated to smoking cessation and improved health? If it does, it needs to provide consistent funding to the programs in the Fund for a Healthy Maine.

Lawmakers should examine the short- and long-term costs and savings of the programs and make a clear statement about their intent. There’s no reason for the health programs in the fund to get special protections that health programs out of the fund do not receive, but they also should not be treated as an auxiliary Rainy Day account as they sometimes are now.

The revenue reprojection offers an excellent opportunity for lawmakers to pursue that question and the many others that were raised so urgently when it seemed a crisis was at hand.