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What Perry's Stance on Medicaid Expansion Means to Texas Hospitals

Margaret Dick Tocknell, for HealthLeaders Media, July 11, 2012

I laughed out loud the first time I read Perry's letter. It seemed calculated to appeal to the anti-big government crowd. But as I write this, I wonder if Perry didn't make a brilliant political move.

Is Secretary Sebelius really going shrug her shoulders and let Texas off the Medicaid hook? Is Perry really going to walk away from an estimated $70 billion in federal money? It's doubtful.

With 6.2 million uninsured individuals in Texas, the state has some clout in terms of negotiating with the federal government. In his letter, Perry says he "looks forward to implementing healthcare solutions that are right for the people of Texas" and asks Sebelius to support him in that effort.

On the flip side, Perry and the Texas legislature face a $6 billion shortfall in the state's current Medicaid program. That bill comes due in 2013. The legislature has never been shy about reducing Medicaid benefits. Only pregnant women, children, and disabled adults quality for the program now, so there's not much that can be cut there.

Texas just trimmed physician reimbursements by 2%, which reduced the number of physicians willing to take on new Medicaid patients.

Remember, the PPACA goal is to get more people under the insurance umbrella. A little give and take could be all the Perry needs to jump into the Medicaid expansion fold.

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2 comments on "What Perry's Stance on Medicaid Expansion Means to Texas Hospitals"


Lou DeNino (7/27/2012 at 12:14 PM)
I think there is penty of room for negotiation between Texas and HHS on perhaps phasing-in expansion of medicaid in exchange for waivers allowing Texas to launch an "experiment" in tailoring benefits and co-pays for medicaid beneficiaries. It could be a win-win and Texas could take the credit and claim victory. It's all in how you spin it.

Karen Willingham (7/12/2012 at 1:08 PM)
I'm hoping that the political factors do not play a part in the healthcare structure that has been set forth by our President and that over time many states will allow the plan to role out and see the benefit in providing healthcare for everyone. This will benefit the economy by increasing the employment market, with healthcare growing as rapidly as it is, this is sure to bring even more jobs in healthcare. We need to stop fighting the programs that are going to benefit the people, help the needy, and the economy.