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Texas Braces for Medicaid Status Quo



By opting not to expand Medicaid, Texas is passing up an estimated $90 billion in federal funds over the coming decade, leaving its healthcare providers, especially hospitals, in a tough financial spot. Rural care facilities are especially vulnerable.



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.
Todd Madden (6/5/2013 at 5:49 PM)

"...They don't reap the benefit of seeing more insured patients, and their reimbursements for Medicare and Medicaid are being cut." So let me get this straight, hospitals are somehow so much better off with many more Medicaid patients when the reimbursements are already well below cost and potentially going lower??? And oh by the way, those would be Medicaid beneficiaries by definition would have subsidized insurance and when something is subsidized consumers consume more of it. Looks to me like expanding Medicaid is just another way of increasing a negative margin revenue source and then expecting to cost shift those loses to employers. Hospital CEOs just think that will never stop.
gary (6/5/2013 at 5:34 PM)

The only thing more mind-boggling than the TX govt simply passing on this amount of federal dollars and millions of new jobs this revenue would create, is the lame excuses given to gloss over this ideological (and illogical) driven decision. Politics at its worst.
Thomas Spurgat, MD MBA (6/5/2013 at 4:48 PM)

You are forgetting one minor detail. There are not enough providers to handle Medicaid expansion. The current Medicaid provider contract is very onerous and should not be signed by providers without legal advice. Texas Medicaid is very poorly run and has way too much paperwork for providers to participate. The Texas OIG is currently on a witch hunt to prove (not very successfully) there is massive Medicaid fraud. Last, why not get people back to work so they qualify for traditional insurance? More government welfare is not the answer.