Jason Morales, a Service Employees International Union 1199 Healthcare member...

Jason Morales, a Service Employees International Union 1199 Healthcare member from the Brooklyn borough of New York, holds a sign as health care workers protest proposed cuts in the state budget at the Capitol in Albany. (June 7, 2010) Credit: AP

ALBANY - Lawmakers approved hundreds of millions of dollars in reductions to health care spending last night, though last-minute negotiations spared programs for seniors and the poor.

The health care cuts and savings, valued at $775 million per year, are part of the still unfinished $136-billion state budget for this year. Gov. David A. Paterson included them in the emergency spending bills needed to keep state government operating for another week because the budget is 69 days late.

Paterson and leaders of the legislature's Democratic majorities hammered out the health care proposals in secret. They call for $385 million in cuts, more than $300 million from a renewed crackdown in Medi-caid fraud and $70 million from reinstituting state approval of changes to medical insurance premiums. Together, the savings are about 1 percent of state spending on health care.

Assembly Speaker Sheldon Silver (D-Manhattan) said his chamber endorsed the reductions because most originated with the Democratic majority. To reject them, he added, would mean an unacceptable shutdown of government.

Silver called the health care cuts "unfortunate" but said, "These are tough times and I think everybody has to understand that."

Austin Shafran, a spokesman for State Senate Democrats, agreed, saying, "These are significant cuts that we have agreed to."

Tying the health care proposals to the continued operation of state government is an unprecedented move stemming from Paterson's frustration with the slow progress of budget talks, experts said. No governor in modern times has included components of an unfinished budget in emergency spending bills.

Silver said, "It's something we've encouraged the governor to do, especially where there are agreed cuts" between lawmakers and the governor.

Still, hospitals and unions representing health care workers have been examining the legality of Paterson's action, which he revealed Friday. Asked whether they would file lawsuits, officials at the Greater New York Hospital Association and Local 1199 of the Service Employees International Union said, "We're not ruling anything out."

About 20 SEIU members stood outside the ornate Senate and Assembly chambers holding signs and chanting, "No more cuts. Enough is enough!"

Democratic lawmakers emphasized they had mitigated some of the health care cuts by shifting money between programs. They touted the restoration of Aging Office services targeted for elimination: $644,000 for the Congregate Services Initiative and $63,000 for the Patients' Rights Advocacy Hotline.

But Sen. Kemp Hannon of Garden City, the top Republican on the Health Committee, said the spending cuts were lopsided because they only affect providers and not entitlement programs such as Medicaid. He also blasted the secrecy surrounding budget deliberations: "A closed process doesn't work and these are bad decisions."

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