COLUMBIA -- State budget writers Wednesday gave preliminary approval to parts of the state spending plan that would pay doctors less for caring for Medicaid patients, lock in lower welfare payments and give colleges less for operations.
The $5.2 billion spending plan is due on the House floor for debate March 15 as legislators close a $700 million spending gap brought on by the loss of federal bailout cash and swelling rolls of people who lost jobs and found their families eligible for Medicaid.
That has put the Department of Health and Human Services at the center of much of the budget debate.
The state's Medicaid programs are $225 million short on cash for the current budget year. A $100 million state bailout will keep payments flowing to doctors and hospitals through April.
Anthony Keck, the Medicaid agency's director, laid out plans Wednesday for the budget year that begins July 1 that would save $201 million. That includes a $125 million cut in doctor and hospital reimbursement rates.
And there's also a plan to temporarily delay $36 million in payments to managed care groups that pay doctors and hospitals.
"It's a little sleight of hand. But I didn't hide anything and I said it's a cash-management strategy," Keck said before explaining the proposal to legislators.
House Minority Leader Harry Ott, a St. Matthews Democrat, said it would be a terrible precedent.
Keck said the delay would amount to paying a bill due at the end of one month a few days later at the beginning of the next month. He said the agency already has authority in its contracts with the medical care organizations and medical health networks to change when they are paid. "You want me to cut more doctors? That what you want me to do?"
Ott said the rate cuts to doctors and hospitals would take $500 million out of the state's medical care system when federal matching dollars disappear and cost jobs, particularly at rural hospitals. "The problem is, if he happens to be wrong, rural hospitals across the state are at risk of having to shut their doors," Ott said.
Keck said that woudn't happen.
Meanwhile, the budget committee locked in place more than $25 million in spending reductions the Department of Social Services made during the past several months as it erased a deficit for the current budget year.
Those spending reductions included reducing the average monthly checks for a parent with two children from $270 to $216. People getting the checks have to work at least part time or be in a training program. "Those cuts will remain in place," said state Rep. Brian White, an Anderson Republican who handles the agency's budget.
Some of the biggest budget losers, too, were the state's public colleges. During the past three years, $110 million in federal bailout cash was used to spare them from deep layoffs and cutbacks in the depths of the recession. But that money is gone now. Meanwhile, budget writers have given initial approval to cutting more than $16 million from their general tax budgets. That's an overall 5 percent reduction.
The state's largest colleges take the brunt of that. Clemson University would lose nearly $4 million of its $62 million taxpayer-funded budget. The University of South Carolina would lose $6 million from its $101 million base budget. The Medical University of South Carolina would give up $3 million for its $54 million base.