ATLANTA - Two things the state won't ask poor and disabled Georgians to do to keep the budget in line is pay for their own emergency ambulance rides and limit how many brand-name prescriptions they can get per month.
Those were both proposals before the board overseeing the Department of Community Health, but on Wednesday board members found other ways to shave as much as $347 million off the state's Medicaid and PeachCare for Kids programs.
Also cut from a list of cost-saving budget measures was a proposal to limit those on the Medicaid health-coverage plan to no more than four brand-name drug prescription orders per month without prior approval.
The removal of the two controversial proposals - valued at $29.4 million - came as the board unveiled a slightly tweaked budget it plans to send on for review to Gov. Sonny Perdue for the fiscal year beginning July 1.
The board originally proposed doing away with the ambulance rides and imposing the prescription drug limit during an Aug. 25 meeting.
Subsequent review of federal guidelines and the state's own prescription-rebate program ruled out those options, said Carie Summers, the department's chief financial officer.
STILL, THE MODIFICATIONS that were announced Wednesday did little to allay the concerns of several consumer health-care advocates and family members who say that the agency's remaining budget proposal still jeopardizes the treatment of disabled children, the chronically ill and the elderly.
"The families in the state of Georgia need this support," said Alpharetta resident Heidi Moore, the mother of 4-year-old son Jacob, who has Down syndrome and relies on the joint state-federal Katie Beckett Program to fund his speech and feeding therapy. "We would have had to file for bankruptcy by now if we did not have this secondary insurance."
The proposed budget being sent to Mr. Perdue also includes the elimination of Medicaid coverage for adult dental and prosthetic services, and a worst-case scenario under which the Medicaid hospice program would end and eligibility would be cut off for 46,000 Medicaid and PeachCare enrollees.
Department Commissioner Tim Burgess stressed that the budget-drafting process was still in its early stages, noting that Mr. Perdue will unveil his own plan in January and state lawmakers will then work to put together a final version by sometime in early spring.
"Just like last year, we find ourselves in a tough fiscal situation as a state with some tough fiscal decisions to make," he said, explaining the state's Medicaid spending increases 10-12 percent each year.
"I'm quite certain there's not one of you on the board who would choose to debate the things we're debating ... if we didn't have to."
MR. PERDUE ASKED all state agencies earlier this summer to provide him with budget plans for three different scenarios: one assuming next year's budget increases by 5 percent over the 2004-05 funding level; a second model assuming the budget doesn't change at all; and a third showing a 3 percent cut in funds.
The 3 percent reduction model drew the ire of many critics.
That scenario would require middle-class families of children with long-term disabilities to pay a monthly premium in order to retain eligibility under the Katie Beckett program.
The move would save the state $1.5 million by using a sliding scale based on income to determine how much a family would pay.
Lt. Gov. Mark Taylor lashed out Wednesday at the budget, specifically blasting the 3 percent reduction model's plan to end breast and cervical cancer programs under Medicaid.
"This is not the Georgia we should strive to be," said Mr. Taylor, a Democrat who plans to challenge Mr. Perdue for governor in 2006.
Sen. Regina Thomas, D-Savannah, also reacted strongly after learning of the plan's latest form.
"I'm appalled," Ms. Thomas said. "I just see it as a very inhumane thing to cut people who need it the most."
She suggested the state look elsewhere to make cuts.
Reach Brian Basinger at (404) 681-1701 or firstname.lastname@example.org.