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Texas Braces for Medicaid Status Quo

John Commins, for HealthLeaders Media, June 5, 2013

Left holding the bag, of course, will be healthcare providers, especially hospitals. They get the worst of both ends. They don't reap the benefit of seeing more insured patients, and their reimbursements for Medicare and Medicaid are being cut through the federal budget process and sequestration mandates.  

"It's a difficult financial model," says John Hawkins, senior vice president for government relations at the Texas Hospital Association. "Trying to balance those cuts without being able to expand coverage is going to be difficult going forward."

In all likelihood, dwindling funding could mean that some smaller or financially strained hospitals will close. "For rural hospitals that is probably more the reality. In other areas you will see hospitals limit services which can be equally as challenging for their communities," Hawkins says.  

"You are going to have worse health outcomes, particularly in areas where facilities have to limit services. Folks will have to drive farther. Your workforce isn't going to be as productive because of lack of coverage. The bigger impact will be poorer health outcomes and less-productive state."

It's not just the usual public advocacy groups who are calling for expanding the Medicaid rolls. Leading business groups in Texas have called for some sort of action. Hawkins says there has been a "continued drum beat" for expanding the rolls from a wide swath of special interest groups that recognize what is at stake.  

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6 comments on "Texas Braces for Medicaid Status Quo"


Thomas Dodson (6/7/2013 at 1:26 PM)
How can Texas, or any other state for that matter, pass on billions of funds designed to help the most vulnerable among us? Short-sighted leadership is an understatement when describing their leadership.

Phyllis Kritek (6/6/2013 at 1:15 PM)
It is at least worth noting here that while arguments proceed shaped by politically motivated ideological purity or economic self interest "the least among" Texas citizens will suffer from lack of health care. The chronicling of challenges ACA presents might be energy better invested in creative problem solving. Some states are doing just that.

Pete Kelley, MD (6/6/2013 at 12:13 AM)
The carrot and stick at the same time. Medicaid expansion is not the answer. As a pediatric surgeon, I have witnessed the financial impact of Medicaid expansion first hand, through the SCHIP's program. Not only do the uninsured get enrolled, but a number of previously insured patients also convert to Medicaid. In Tennessee, we no longer have "self-pay", uninsured children, however, 65% of the children in the state are now covered by TennCare. The reimbursement rates are significantly below Medicare rates, and the system is run by Medicaid MCO's who make a huge profit by throwing up administrative hurdles and denying claims. The financial impact on pediatric specialists has been incapacitating. The hospitals are doing okay, but the doctors are getting destroyed.