One of the things most reporters I know like best about the news business is they never know exactly what they're going to be writing on a given day. News just happens. In theory, at least, news is fluid and they never have to write the same thing twice.
But as the opening of the January legislative session approaches, I'm getting an uneasy feeling of deja vu. I suspect I'll be rewriting several stories on issues with which lawmakers have already dealt.Politicians talk a lot about allowing states control of their governments and a larger say in national policy. In a lot of areas, it's just talk.
Utah's budget for programs to serve people who are poor, elderly, disabled, mentally ill, etc., is at the mercy of federal whims. State officials who deal with a variety of programs can't just decide what they believe are the most effective programs or where they want to put money.
First, they have to satisfy the federal appetite. And that appetite is ever-growing.
The Health and Human Services budgets were the focus of discussion last week when department heads met with advocates and concerned citizens in Utah Issues' monthly forum. The meeting is an information-, gripe- and idea-sharing session.
The bottom line, it appears, is that federal mandates are going to eat up a huge chunk of department budgets.
In order to satisfy the federal demands, Health and Human Services officials are looking - albeit reluctantly - at programs they can reduce or eliminate.
Dr. Suzanne Dandoy, director of Health, and Rod Betit, director of the Division of Health Care Financing, which administers Medicaid and other low-income health programs, believe they'll probably have to cut about $3 million in state funds from existing programs. And since Utah draws down $3 in federal funds for every $1 the state puts in, it will amount to a $12 million cut from the medical-assistance programs.
A lot of the programs being examined seem awfully familiar. I don't know how many times I've written about attempts to restore the adult dental program to Medicaid coverage. It was a years-long battle. Advocates and officials both supported the program, which was finally restored in July 1989.
It's back on the auction block again as one of the potential reductions.
Income eligibility for the Utah Medical Assistance Program until last year was $289 a month for a one-person household.
When the Legislature raised that income level to $337, 350 people who needed the medical help and fell in that gap were able to participate.
Its fate is also uncertain now. It's on the list Betit and Dandoy presented of where cuts may have to occur. Eligibility could return to $289 a month.
Some of the benefits are just perpetually up for grabs, like the $6 Supplemental Security Income stipend. The state provides people who receive SSI with the extra $6 because SSI payments are so low, well below federal poverty guidelines. For a while after the state started it, it had no choice but to continue, by federal mandate. When that mandate was dropped (it's interesting to note the government can, on occasion, un-mandate), the stipend became vulnerable. And while it seems like a very small amount, when you live on an income that small, any portion of it is significant.
As poor as they are, SSI benefits are far greater than the Aid to Families with Dependent Children (welfare) grants. They had gone without any cost of living increase since the mid-'80s Last year, the state gave the grants a small increase.
Guess what? One of the budget-reducing Human Service possibilities is an AFDC grant reduction.
Some of the things that may be cut are aimed directly at helping someone become self-sufficient and independent. The "Earned Income Disregard," for instance, is an incentive for a grant beneficiary to work and become more stable financially, while maintaining the safety net of a grant. In calculating eligibility for a grant, a portion of earned income is disregarded. That may be reduced.
It's hard to oppose federal mandates when some of them can accomplish great good with things the states just wouldn't get around to doing. Who can argue with a mandate that prenatal care be given to women living up to 133 percent of poverty? Who could disapprove of expanded medical services for poor children - and for more of those children?
But most of the states are really struggling to meet their share of the cost of those mandates. And the feds don't seem to know - or care.
While we struggle to do the things the federal government says "must be done," we may have to let go of some programs that are serving the state very well.
That's not a decision that should be made lightly - or from so far away.