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The Brief: Dec. 6, 2010

Texas got its first taste of a Medicaid-less future on Friday. And the future doesn't look pretty.

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THE BIG CONVERSATION:

Texas got its first taste of a Medicaid-less future on Friday. And the future doesn't look pretty.

According to a report, up to 2.6 million Texans could lose health coverage if the state opts out of Medicaid, as Gov. Rick Perry and other Republican lawmakers have suggested in light of an estimated $25 billion state budget shortfall. But the study, issued Friday by the state Health and Human Services Commission and the Texas Department of Insurance, also called the system unsustainable in its current form.

The report found that, in addition to putting the poor at risk, withdrawal from the program would also lead to a loss of $15 billion in federal funds per year — with Texans still paying federal taxes to support other states' Medicaid programs. County governments and public hospitals, facing increased indigent care costs, would then be forced to foot the bill, the study said.

Perry has floated the opt-out idea while promoting his new anti-Washington book, Fed Up!, but he reined in his rhetoric on Friday following the report's release, making no mention of a complete withdrawal from the program, as the Austin American-Statesman notes.

"Texas, the states and the federal government would be much better served by increasing flexibility and innovation in Medicaid, even block granting funds to the states, so we can tailor Medicaid dollars to best serve the needs of Texas patients, families and taxpayers. I have discussed these issues with other governors and policy experts, and will be working on ways to improve the utilization of Medicaid dollars in Texas," Perry said in a statement.

Perry's words fell in line with the study's recommendation that the state revise how it administers the program rather than outright rejecting it. "Redefining the relationship between the state and federal governments in the administration of the Medicaid program may be a preferable course of action," the report said.

CULLED:

  • Hearings begin today in a case in which, for the first time in state history, a judge will decide whether the risk of executing an innocent person makes the death penalty unconstitutional, as the Tribune's Brandi Grissom reported last week.

"My favorite person that's ever been on this earth is a Jew. How can they possibly think that if Jesus Christ is a Jew, and he's my favorite person that's ever been on this earth?"John Cook, of the State Republican Executive Committee, on criticism of an e-mail he sent calling for a "Christian conservative" speaker of the Texas House. Of incumbent Joe Straus, whom Cook opposes, he added, "I want to make sure that a person I'm supporting is going to have my values. It's not anything about Jews and whether I think their religion is right or Muslims and whether I think their religion is right. ... I got into politics to put Christian conservatives into office. They're the people that do the best jobs overall."

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