King County government and local citizens are facing the consequences of state and federal policies regarding funding of the Medicaid program and the lack of progress on a national healthcare plan. More King County residents are going without health insurance and mental health treatment as a result. These effects were highlighted this week as the Metropolitan King County Council continues their deliberations on the 2006 King County budget.

“King County is forced to rely more and more on local general taxes to pick up the tab that has been left by lack of Medicaid and other funding to cover health care services,” said Councilmember Julia Patterson. “These cuts strain our ability to prepare for large-scale public health crisis like a possible flu pandemic, because more of our local resources are needed to fund direct health services that have in the past been covered by Medicaid and other State and federal revenue sources.”

“It’s unconscionable for the federal and state governments to leave the indigent and working poor behind on the road to economic recovery. It takes a toll on both the people who rely on Medicaid and mental health services, and the King County taxpayers who are indirectly affected by these cuts,” said Council Chair Larry Phillips. “Every one of us will see our health care costs increase to cover the cost of public hospitals like Harborview Medical Center caring for those left without adequate insurance coverage or the mental health services they require.”

The 2006 proposed King County budget includes a 33 percent increase in General Fund revenues to support clinical services provided by Public Health—Seattle and King County, and a corresponding decrease of nearly 18 percent in Federal and State Medicaid dollars. Public Health receives state, federal and local funding to serve the citizens of King County. Revenue from the county’s General Fund has historically made up a smaller portion of Public Health’s budget.

State and federal Medicaid-related reductions for King County mental health programs have also resulted in the loss of care to over 2000 severely mentally ill people not on Medicaid. Funding previously available to treat these people had to be diverted to pay for services for persons entitled to care under Medicaid. Significant numbers of the mentally ill in King County are severely ill immigrants and refugees who are not Medicaid eligible, people experiencing their first bout of mental illness who have not been disabled long enough to qualify for the Medicaid program and chronically and severally ill persons who are too disabled to manage the eligibility process.

Lack of treatment for the mentally ill increases the number of psychiatric emergencies requiring more expensive and less effective public safety and emergency medical interventions. Further mental health reductions of $9 million are projected for King County in 2006 unless the Governor and State Legislature agree to provide a supplemental appropriation when the Legislature meets in January. The President's 2006 proposed budget includes an additional $45 billion in federal Medicaid cuts.

Earlier this week, the council was briefed by local public health officials, who drew attention to the rising number of King County residents who completely lack health insurance – even Medicaid coverage. Dorothy Teeter, Interim Director of Seattle/King County Public Health, noted that the number of uninsured residents in King County is at its highest level in over 20 years. Approximately 15 percent of county residents 18 to 64 years old lack health insurance. Nearly 1 in 5 residents of South King County are uninsured, the highest of any area in King County.

“Lack of adequate Medicaid funding increases costs to local governments at our jails and emergency rooms,” said Patterson. “The lack of a national healthcare plan to address the growing number of uninsured is placing a growing burden on bottom line of local government.”

Medicaid is a federal program that pays for medical assistance for certain individuals and families with low incomes and resources. This program became law in 1965 and is jointly funded by the Federal and State governments to assist States in providing medical long-term care assistance to people who meet certain eligibility criteria. Medicaid is the largest source of funding for medical and health-related services for people with limited income.

The proposed changes to Medicaid for fiscal year 2006 will require that states contribute an additional $527 million, according to the Federal Funds Information for States (FFIS).

For more information on the 2006 Budget, visit the King County Council’s
Budget Web site