In December, a few weeks after his election upset, then Gov.-elect Larry Hogan informed Marylanders that they would need a dose of "strong medicine" to cure the state's structural budget problems created by what he called years of spending beyond our means.

"The tough decisions have not been made, and the wrong decisions have been made for far too long," Hogan said at the time.

Fast forward six weeks, and Gov. Hogan's proposed fiscal year 2016 budget, released last week, carries through on his promise by holding statewide spending growth to just 2.4 percent, despite a 3.5 percent increase in revenues.

The bottom line: all of Maryland will be tightening its collective belt.

While we're still digesting the proposal and modeling its implications for Maryland's hospitals, our initial analysis reveals the most disappointing impact on our field to be $14.5 million in waiver-related savings that the legislature last year agreed would be used to reduce the Medicaid hospital tax. Under the new administration's budget, that money will instead be diverted back to the state's general fund.

This is among the many reasons that reducing and eliminating the tax remains hospitals' top priority. As long as it exists - and remember, it began in 2009 as a temporary fix to Medicaid's then-hemorrhaging budget - it will be a target for budget balancers looking to siphon money to other parts of the state's coffers. While we understand and appreciate the new administration's effort to be equitable in balancing the budget, our commitment to obtaining a concrete schedule for the Medicaid tax's phase-out is as strong as ever. We've made the case, and the administration has heard us, that the Medicaid hospital tax can go a long way toward their goal of cutting taxes. But for now, fiscal reality dictates otherwise.

The new budget also looks to hospitals for more than $24 million in Medicaid savings (resulting from what the administration believes is the continued reduction in uncompensated care due to Medicaid expansion) for fiscal years 2015 and 2016. We're working closely with the Health Services Cost Review Commission and MHA's Executive Committee to determine the best way to achieve those reductions while causing the least harm to hospitals.

Perhaps the most telling thing about Gov. Hogan's budget is not how individual interests are affected, but rather that it recognizes - and media pundits and reasonable people on both sides of the aisle seem to agree - the need for an honest reckoning of Maryland's finances.

As we work through the details of Gov. Hogan's proposal, we will continue to reinforce the idea that Maryland's hospitals are part of the state's budget solution. As the state reins in spending, so too are hospitals - the state's largest private employers. As the state seeks efficiencies in its operations, so too are Maryland's hospitals, which employ more than 100,000 people. As the state innovates to provide better, less costly services, hospitals, guided by global budgets and population health principles, are doing so as well.

In many ways, the governor's fiscal vision mirrors that of the modernized waiver's - better quality, delivered more efficiently and at a lower cost. That's something we can all get behind.