There’s been a lot of worry among advocates and others regarding the effects of the economy on health reform. Recently, Governor Patrick announced a number of midyear budget cuts, and many people in health policy were worried those would include the state’s health programs. So far, they (mostly) haven’t.

The state has not cut back on eligibility for its subsidized programs, it hasn’t enacted any enrollment caps, and one cut many people were fearing – paying for outreach workers to get the word out to mostly low-income residents – also didn’t happen. (In fact, I was at a Connector board meeting in Boston recently at which Leslie Kirwin – Secretary of Administration and Finance – congratulated the group for having mostly escaped the budget ax.)

One place that DID get cut was the state’s cost control council. That’s a state agency created to keep costs down, and as a result of midyear cuts, they had to lay off staff. So some are saying that’s unavoidable, and others say it’s short sighted, since the purpose of the council was to keep costs down. But the tasks of the council are supposedly being subsumed by other state departments.

The bigger question, though, is how much more need there will be if the economy really struggles. Employers will have less money to put into health plans. More people will lose their jobs and therefore their health insurance. All that is going to put more burden on the state’s health programs, and it doesn’t look like the policy makers know yet whether the state can keep up with the need.