Michigan Votes Forum

Introduced in the Senate on March 3, 2004, the Senate version of the Fiscal Year (FY) 2004-2005 Department of Community Health budget. (Note: Gov. Jennifer Granholm’s proposed budget for this department is Senate Bill 1036 .) This appropriates $9.637 billion in adjusted gross spending (including restricted fund and federal dollars), compared to $9.417 million, which was the FY 2003-2004 amount enrolled in 2003. Of this, $2.974 million will come from the general fund (funded by actual state tax revenues), compared to the FY 2003-2004 amount of $2.561 million. Medicaid spending rises $229.5 million over the previous year. The Senate version authorizes approximately $95 million less gross spending than the governor recommended, but $500 million more general fund spending, mainly because it does not include some $400 million in new tobacco tax and estate tax revenue proposed by the governor. Much more information on Michigan’s budget is available at Hot Topics: Michigan’s Budget Challenge at www.mackinac.org/4964

The vote was 24 in favor, 14 opposed and 0 not voting

(Senate Roll Call 169 at Senate Journal 33)

Click here to view bill details.

Senator Cherry's statement is as follows: I rise today to unfortunately say that I will be voting "no" on the 2005 budget for the Department of Community Health. I say that also recognizing that this is the first step of a long budget process, and I'm hopeful that we can still address the problem that exists in the budget, making it both fiscally responsible and able to address the needs of our citizens. I also just want to commend the chair of the subcommittee. He has been more than willing to work through issues and has been able to do some things that are very positive. For example, as you know, the adult dental program has been restored, and it's very important, but there are still other issues that need to be dealt with. I'm voting "no" because this budget in its current form is neither fiscally responsible nor able to meet our citizens' needs. The budget is more than $500 million out of line with the Governor's recommendation, and that is because we have not addressed any funding source for the additional funds that have been added to the budget. That's half a billion dollars that relies on general funds to make up this huge hole which we do not have, as all of you well know. In addition, the chair of the committee has also talked about other funding issues that may need to be dealt with as we proceed in this budget. At that same time, we've also eliminated some of the funding increase for Healthy Michigan programs, including chronic disease prevention, maternal and children's care, and smoking cessation programs. And, again, while I support adult dental, the restoration of that program and podiatry and chiropractic care, we still need to be putting some funds to invest in prevention programs. Finally, this budget impairs our ability to help our most vulnerable citizens. Changes in the way disproportionate share payments are made will hurt hospitals that serve a high concentration of Medicaid patients. At a time when the economy is hurting and health care costs continue to soar, limiting in any way our ability to help those most in need is simply unacceptable. So, Mr. President, the reasons for not supporting this budget are many. We do need to address the source of funding so that we are not placing a huge hole in our General Fund. I hope as the process moves forward, we will deal with all of those issues and be corrected, and by the time it comes back, I will be joyfully voting to support this budget.

Senator Scott's statement, in which Senators Clark-Coleman and Basham concurred, is as follows: I also rise to speak about the impact of this bill, especially Section 1717 in this budget dealing with the "dis" payments. Instead of taking money from the regular "dis", which has not been increased since 1991, mind you, the state should find new money to help hospitals with going to Medicaid rolls. Detroit hospitals would be forced to forfeit roughly $4.3 million of 86 percent or the $5 million that would be redistributed to the hospitals that receive little or no dis money. Five of the Detroit Medical Center hospitals--Children's Hospital of Michigan, Detroit Receiving Hospital, Harper Hospital, the Rehabilitation Institute of Michigan, and Sinai Grace Hospital--would collectively lose $3.8 million under the boilerplate. Children's Hospital of Michigan, which is located in Detroit and is part of the Detroit Medical Center, but services the entire state, would alone lose nearly $2 million. There is a reason Detroit hospitals receive the bulk of the "dis" money; they provide the bulk of the medical care for the Michigan indigent population. So, Mr. President, I will be voting "no" on this bill until we can come up with some better solutions to help our hospitals.

Senator Hardiman asked and was granted unanimous consent to make a statement and moved that the statement be printed in the Journal. The motion prevailed. Senator Hardiman's statement is as follows: I rise in opposition to this amendment. I appreciate the work of all of our hospitals in Michigan. I appreciate the wonderful job they do in helping to save lives, but I don't believe that we know that there is more money available, and if there is, that's wonderful because I believe that they can all use it. I appreciate the work of the chairman and of the committee on this very important budget. This bill more fairly distributes the $45 million of Michigan's Medicaid disproportionate shared fund. The intent of the disproportionate shared fund is to bring necessary funding relief to Michigan hospitals providing high amounts of Medicaid services. Spectrum Health System in Grand Rapids receives zero dollars from the 2003 disproportionate share distribution, despite having the second highest number of Medicaid, medical surgical days in this state, which serves as a leading indicator of Medicaid patient treatment volume. In Southeast Michigan in 2003, Southeast Michigan received 94.5 percent of the total disproportionate share distribution, while accounting for 54.7 percent of the Medical surgical days. In 2003, West and Southwest Michigan received 3.3 percent of the disproportionate share distribution, while accounting for 18.4 percent of the medical surgical days. So I believe that this is a more fair distribution of the dollars we do have available. I would love to see more dollars available for all of the hospitals, and if that happens, then I think that is good for Michigan.

Reps. Phillips, Dennis, Accavitti, Zelenko, Byrum, Hopgood, Vagnozzi, Brown and Law, having reserved the right to explain their protest against the passage of the bill, made the following statement: "Mr. Speaker and members of the House: I voted 'No' on Senate Bill 1063(H-1) because it balances the state's budget on the backs of patients. This bill creates winners and losers in the health care arena in Michigan. It slashes health care for more than 40,000 individuals, including 11,000 young adults ages 18-21 who rely on Medicaid for the medical treatment they need. At the same time, this bill holds harmless pharmacies and emergency room physicians from the tough economic conditions of the state's budget. This bill wrongly prioritizes reimbursement rates above and beyond those of other health care providers over the basic health care needs of more than 40,000 Michigan citizens. This bill also strips our commitment to the well-being and the quality of life of Michigan's citizens by cutting the Governor's recommended prevention programs. When Michigan ranks the third worst among states for its rate of obesity and has been among the ten heaviest states for the past 14 years and there are still more than 16,000 tobacco-related deaths in Michigan each year, Michigan needs to invest in preventative health programs to ensure a healthier population in the future. Every dollar the state spends in prevention will save the state two or more dollars in the future. We cannot afford to continue to ignore the growing, and expensive problem chronic diseases. Senate Bill 1063 is a short-sighted 'fix' in a tough budget year and ignores legislative responsibility for prioritizing the quality of life of Michigan's citizens and providing a safety net for those that have found themselves in tough times during this economic downturn. The Governor was able to put forward a balanced budget that preserved these priorities, but Senate Bill 1063 is far from providing for the basic health care needs of Michigan citizens."

Rep. Bieda, having reserved the right to explain his protest against the passage of the bill, made the following statement: "Mr. Speaker and members of the House: I voted 'No' on Senate Bill 1063 (H-1] because it balances the state's budget on the backs of patients. In addition, this bill also strips our commitment to the well-being and the quality of life of Michigan's citizens by cutting the Governor's recommended prevention programs. When the state ranks the third worst among states for its rate of obesity and has been among the ten heaviest states for the past 14 years and there are still more than 16,000 tobacco-related deaths in Michigan each year, Michigan needs to invest in preventative health programs to ensure a healthier population in the future. We cannot afford to continue to ignore the growing, and expensive problem chronic diseases. This bill is a short-sighted fix in a tough budget year and ignores legislative responsibility for prioritizing the quality of life of Michigan's citizens and providing a safety net for those that have found themselves in tough times during this economic downturn. I believe that Governor Granholm did a good job in putting forth a balanced budget that preserved these priorities, but Senate Bill 1063 is far from providing for the basic health care needs of Michigan citizens. Because of these deficiencies, I voted no on Senate Bill 1063."