Lawmakers Discussing Dropping Health Care Program
Some Republican lawmakers — still reveling in Tuesday’s statewide election sweep — are proposing an unprecedented solution to the state’s estimated $25 billion budget shortfall: dropping out of the federal Medicaid program.
Far-right conservatives are offering that possibility in post-victory news conferences. Moderate Republicans are studying it behind closed doors. And the party’s advisers on health care policy say it's being discussed more seriously than ever, though they admit it may be as much a huge in-your-face to Washington as anything else.
“With Obamacare mandates coming down, we have a situation where we cannot reduce benefits or change ...
Comments (39)
m smith
Why stop with Medicare.
Why doesn't Texas just leave the Unitied States.
W Bush could be your King.
You could throw all of the sick, old, mame, poor and moderates out of the Kingdom of Texas.You could give all of the needy one way tickets from the Kingdom to Alabama and they could live with Karl Rove and work at one of his secretly funded Crossroads groups. (You could keep the ones you are using as servants and sex slaves of course)
The Kingdom of Texas could continue to pollute its land and people with no restrictions.
The Kingdom would not have to worry about gerrymandering legislative districts anymore.
Halliburton could be tempted to move their foreign corporate headquarters to the Kingdom.
Of course you might have to defend your own borders, grow all of your own food, secure an uncontaminated water supply that was not polluted by all of the natural gas fracturing going on. And even a Kingdom has taxes.
Robert Nagle
Wow, this article neglected to mention the most important data point: what is the maximum household income to qualify for Medicaid in Texas vs. for other states. What you will find is that Medicaid eligibility was ridiculously strict in Texas; Texas has been underfunding Medicaid for a long time. Yes, of course it will cost Texas a lot of money to achieve parity with most states. The feds will help out a lot with it, but ultimately it is the state's own fault for providing such inadequate coverage in the past. I fear that budget pressures however will make it impossible for Texas to accept the federal help without restructuring its tax structure (i.e., increasing taxes).
http://www.washingtonpost.com/wp-dyn/content/article/2010/01/20/AR2010012005042_pf.html
In Texas, parents qualify for Medicaid only if their family income is below $5,720, while in Virginia, the limit is $6,380. In Wisconsin, New Jersey, Maine, Minnesota, Illinois, Connecticut and the District of Columbia, the cutoff is $40,000 or higher. In Maryland, it is $25,500.
The legislation would set a single standard for Medicaid eligibility, about $28,000 or $33,000 for a family, and the federal government would pay almost the entire cost of newly eligible people. That means that states with looser standards would continue to pay as much as half the cost for a broad swath of people that in other states would be paid for almost entirely by the federal government.
Scott Chase via Texas Tribune on Facebook
Talk about short-sighted. Under healthcare reform, the federal government is paying for the expansion of Medicaid so Texas would lose those billions of $. Then, there would be a massive shift of costs to hospitals' ERs and counties and cities since the need for health care wouldn't go away. Local taxes and insurance premiums would sky-rocket.
Sharon Arnoult via Texas Tribune on Facebook
Which the GOP of this state would promptly blame on "Obamacare." The willingness of these people to sacrifice the health and even lives of hundreds of thousands, if not millions, of people in the name of partisan politics is disgusting.
Joseph Meyer via Texas Tribune on Facebook
My recollection is that some Republican members of Congress claimed that Obama was trying to destroy Medicaid.
Irene Solnik via Texas Tribune on Facebook
There are not words I can use in public to say what I think. the closest is when they go home to their kennels, I hope their mothers bite them!
Clay Boatright via Texas Tribune on Facebook
To throw millions of people over the side of the ship with absolutely no lifeboat would be an abomination beyond belief. Families and people with disabilities wait years for help from the government, because nobody else is engaged, and now that one source of support is in jeopardy. Unbelievable.
Tim Hurst via Texas Tribune on Facebook
idiot texas legislature.
GW Priester
Why is the rich always want to balance the budget on the backs of the poor? Instead of opting out of Medicaid and Health Care for the young, why not just charge the very wealthy a few dollars more. The wealthy can think of it as REAL Christian Charity.
GW Priester
Oh and one other thing. If the current watered down health care initiative was enacted during the rein of George W. Bush I sincerely doubt it would be called Bush Care.
So, get off this Obamacare nonsense. In the long run it is going to save money, not cost more money.
Kim Batchelor via Texas Tribune on Facebook
Atheists can ignore this comment, but given that the NATIONS are judged in Matthew 25:31-45 by whether or not the sick are cared for, any legislator who votes for this shouldn't step foot in a church again. Jesus hates hypocrites.
Diane Owens via Texas Tribune on Facebook
Apparently these legislators favor "survival of the fittest" over "love thy neighbor." Who needs federal death panels when all we have to do is let the market ration health care.
Scott Kilpatrick via Texas Tribune on Facebook
This is the kind of article that should be sent to Republican family members en masse. Who but the most cynical right-wingers would rally behind the party on this one?
In the eyes of Texans, the GOP has an unfortunate monopoly on common sense -- reading about this kind of shenanigan is the only remedy.
Evelyn White via Texas Tribune on Facebook
In Texas.... Unfortunately, there is no "sound public policy". By the time they write the criteria to qualify...and underfund the offices that employ people to review applications from folks who apply for the assistance, which delays approval by months, if not years, ..... nobody is ever enrolled in the program. That's how Texas runs its "state run" programs for the underprivileged. They make it nearly impossible for anybody in need to receive any assistance at all.
Kathy Smith
Unbelievable posturing. Sounds like the "seceding from the Union" talk of the past 100 years. Maybe the state would save, but what about Texans? We have paid & will continue to pay into Medicaid & receive zero benefits from it. So....as individuals we will be funding on a national scale & local? How is that winning?
Samdavis
Kill Medicare and Social Security - what an ambitious and caring agenda. I just read about two kinds of Christians, Sermon on the Mount Christians and Revelation Christians. We've got a legislature of Revelation Christians not the least of which is my local congress varmit, Randy Weber (R-Pearland).
These plans are just the tip of the iceberg. Perry is rushing through approval of two coal-powered plants, one in Matagorda and one in Corpus, so they can beat new emission standards that take effect on January 2.
The only solace is that much of this effort will be tied up in court for years. Given the makeup of the current Supreme Court I have real doubts if they would reject the state's efforts.
Roy Rogers
Yes, the conservative Christain right practicing what they preach....
bret brittier
Seniors Tea Party members and those seniors voting Republican should now be happy. Conservatism is STARTING WITH THEIR HEALTH CARE, a BIG thank you to ALL SENIOR TEA PARTIERS AND REPUBLICAN SENIORS. SENIORS ON FIXED INCOME CONSERVATISM STARTS WITH YOU - MERRY XMAS
K. Bridgewater
Rep. Alan Grayson described the Republican health care proposal: "Don't get sick, and if you do, die quickly." See his compelling YouTube speech before Congress. The Heritage Foundation doesn't care about the healthcare of Texans; it cares about how to help the rich get richer. They suggest putting corporate health industries on life supports before doing the same for human beings. The plan is to cut taxes without regard to ethics or the impact on individuals and families. Medicare for all is a far better solution for saving money and providing the services everyone deserves. In Canada their highly popular program began in a province.
The unemployed haven't just lost their jobs; they have lost their health care. Workers are not just worried about losing their jobs, they worry about the health care needs of their family members. The Republican health care plan is not only a blank piece of paper, it is devoid of moral standing. Miserliness about taxation is slated to cause misery among sick and disabled Texans. When Texans refuse to share in the care for the sick, the federal Medicaid money will dry up. Then who will live and who will die?
Hypocrisy screams out from the normally sanctimonious. How can anyone who calls himself a Christian not follow the basic Christian directive of "Care for the sick"? Christ didn't add, "As long as it doesn't raise your taxes."
How can someone who has taken the Hippocratic Oath speak against the improvement of Medicare? Forgetful? Hypocritical?:
"….I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm."
K. Bridgewater
Medicaid money currently keeps men, women, and children alive. In Canada (and all the other industrialized countries) when people get sick, they focus on getting well. In Texas, if you get sick, you worry about whether you can keep working, how long your savings can last, and whether you will lose your house. Medical debts is the leading cause of bankruptcy in the U.S.
The only reason to get rid of Medicaid will be because we all get Medicare. Simple. Fair. Far less expensive. Ethical.
Barbara Rubin
In this 1988 article from the Times, Texas medicaid reimbursement rates were so low that few physicians could afford to accept such patients. That left some poor Americans crossing into Mexico for care by their free clinics in a stunning reversal of immigration complaints commonly heard in the US.
http://www.nytimes.com/1988/10/17/us/health-care-on-the-border-poor-go-to-mexico.html?pagewanted=all
This medicaid shortfall is the result of asking the wrong questions. This article looks to the potential savings in denying people health care. Why not look at the savings possible through routine health care for people before they develop chronic diseases? It ignores the huge savings in health care costs possible through reducing pollution. There are huge losses in productivity from environmentally related conditions of asthma, heart disease and cancer. You can spend money to prevent illness or you can spend it on housing the sick who can't get well and go back to work. What are the costs of supporting the children with deceased or dying parents? More than a hundred thousand new cancer cases were predicted for Texas in 2010 here:
http://www.dshs.state.tx.us/tcr/Expected/2010expected/2010Expected-statewide.pdf
Cancer (and any chronic illness) means destitution for most people without excellent insurance coverage unavailable even to those with middle-class incomes. Since there are no complaints here about Medicare being a burden, wouldn't that speak to the wisdom of a public option at all ages? Costs can be adjusted across the nation instead of just within a single state. That is what the insurance game would call a great advantage in business. Therefore, it makes sense in government as well. Why should anyone profit by illness? If the term, 'socialism' comes to mind and induces a panic attack, try calling health care a right instead of a commodity to be bought and sold. That takes care of the political stigma being attached to the offering of universal health care to citizens in the US.
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Barbara Rubin
www.armchairactivist.us
Peter Jones
I was born and raised in Texas. My great grandfather was the sheriff of Temple County. We are Southern Baptists. My grandmother lived for 105 years. She was as deeply spiritual woman as any I have encountered in life... She saw this coming. This generation of selfish warmongers who wrap themselves in their false pretentious belief in Christ.
I learned to love Christ and human beings with all their frailties through my grandmother's and my parent's eyes in a church that taught me to take care of the old and needy. These parasites who claim Christ as their savior and preach that the poor, old, and frail among us should be left behind in interest of their insatiable need to accumulate wealth will receive their due. Unfortunately, those of us who must live among them will suffer along with them.
These notions of cutting off health care for the poor among us will be the death of the GOP. God forgive those heartless souls for they know not what they do.
Doctor Sambo
Y'all are missin' the point. This is the new-fangled, Rick Perry/Texas legislature job creatin' program. You see, here's how this good ol' boy is gonna hunt.
First, we'll spur local entrepreneurship by stimulatin' the growth of new business. In this case, companies whose speciality is to clean up them dead folks. Ya know, the one's who are too lazy to leave the state to get medical care (good for nuthin's). With thousands of new rotting corpses at home each year - causa them poverty folks ain't willin' to pay for their medical care, that's sure to make a stank. These new small businesses will grow. Grow, I say, grow.
Second, we'll help neighborin' states with their industry. Fer example, Illinois. They have that there Caterpillar company -- the one that makes them there heavy diggin' machines. Well, with all of the new paupers graves that we're gonna need for all them dead poor sick folk and their children, we'll be needin' machines to do the diggin'. We reckin that there will be to dang many graves to dig for even Sheriff Arpaio's convicts (who we can borrow for cheap).
You see? Job creatin'. The Texas way. Now, you liberals quit yer bellyachin'. There ain't gonna be not dead bodies in the streets. The Texas Republican's got her covered.
Rick Willis
I don't know about the rest of you but if Texas sets up its own system I smell lots of private contracts paid from state funds. And I bet you can guess who wil get the contracts.
jeff stone
The real issue here is it is time to do some serious Texas Constitution reform. How many of you realize a large portion of our State Budget is dictated in the Texas Constitution? Instead of doing it the smart way, we allowed our legislators write parts of the budget into the constitution. So instead of cutting funding to other state programs (which they can't because its in the constitution) they have to do stupid stuff like this.
Personally I have lost faith in the people of Texas. As a majority we continue to elect idiots to office because God knows why. We have continued to go backwards anytime we had the opportunity to fix the issues because we are lazy and ignorant of the issues. We allow ourselves to be bamboozled by our elected officals.
Perhaps its time those of you that haven't taken the time to read what we have allowed our elected officials to do go and pick up a copy of our constitution and read it.
Rachel Russell
Oh, great, I am a very ill disabled person on SSI, and Medicaid is all I have. And the Republicans keep cutting social programs and payments to doctors as it is! Sickening. I'm going to have to move. I am a native Texan, but feel abandoned by my state.
It's already difficult enough trying to find specialists whom will see me with Medicaid. I am so sick that Perry is govenor, no King of Texas again! I swear, I am with stupids, most the folks in my state.
Gritsforbreakfast
Brilliant, kick Grandma out of the nursing home. That'll definitely solidify the GOP majority.
Truth Hurts
Amen Kim Batchelor and Rick Willis! There is an appropriate scripture mentioned at my church today: ""No one can serve two masters. Either he will hate the one and love the other, or he will be devoted to the one and despise the other. You cannot serve both God and Money." Matthew 6:24
The GOP serves money, specially in Texas. And it's all about state contracts.
Leslie Cunningham
This is pretty incredible. With the economy the way it is, and so many people desperately needing these public services, there is a serious proposal for the state to drop out of not only Medicaid but also the Children's Health Insurance Program. Sen. Jane Nelson said "dropping out of Medicaid was worth considering — but only if it made fiscal sense without jeopardizing care." What planet is she on??? I guess the same one as Gov. Perry--I believe I heard him correctly in a radio interview saying that people should get help from charity and their churches or have private insurance. This is the Ron Paul position.
My union, the Texas State Employees Union, has always advocated for state services as well as the particular job concerns of our own members. We will have our hands full in the upcoming legislative session.
Fil onious
Im sure after one of our own Texas State Representatives, TARA RIOS WAS INDICTED ON 3 COUNTS OF MEDICAID FRAUD, this surely doesnt help those that follow the law and those that truly need the help. Maybe since she is facing a MINIMUM MANDATORY 6 MONTH SENTENCE IN FEDERAL PRISON, we can purge some of the criminal health professionals who abuse the system and perhaps deter some others from following the criminal path.
Robert Blum
Take a deep breath and think about what the state of Texas legislatures are considering: Texas would be standing up for states rights by implementing the process of 'nullification'; a legal theory that a U.S. state has the right to nullify, or invalidate, any federal law that any state deems unconstitutional. If successful, not only would the state of Texas be spared a continuing, unsustainable, budgetary path mandated by the federal government but Texas would be increasing the incentive for other businesses to relocate to the state due to a lower tax burden.
Truth Hurts
Robert Blum, that's awesome! Let's screw the poor and children out of health insurance so we can uphold some dubious obscure legal theory rooted in South Carolina's effort to dodge taxes in 1832 and in the 1950s, the South's desire to keep racial segregation as an American institution. That's taking the moral high ground.
This is the bottom line. Sometimes, doing the right thing costs money ... and doesn't end with someone getting rich.
Nullification is just another word for Anti-American and Un-Patriotic.
Barbara Rubin
The issue of State's Rights comes up frequently in this type of discussion and is worth pursuing. Is the goal to be a good American or a rich Texan (or any other state's name here)? The idea of states having the right to mandate that people below a certain income level can't access any health care is a frightening one. Certain national standards must exist and the right to survive if you get cancer or MS can't be rated in terms of your wealth and 'status'. Particularly when you consider that Texas is well above the national average in injury and illness brought on from employment in the private sector.
http://www.law.uh.edu/healthlaw/research/oiistudy.html
Will you force the private sector to provide needed care that their actions caused? Good luck with getting that to happen unless you begin to monitor pollution and safety in the workplace. Of course that means more of those pesky regulations 'hobbling' businesses. I
You could always deport your sick to other states I suppose. In the US, that means losing a third of your adult population. You'll have to hire a lot of bus drivers. See “A Nation of Patients” here:
http://armchairactivist.us/2010/03/08/a-nation-of-patients/
sgre144
One might obtain some additional insight from, http://www.heartland.org/healthpolicy-news.org/article/27539/New_Federal_Medicaid_Mandates_Force_Unpleasant_Choice_for_States_.html . One of the co-authors, Arlene Wohlgemuth, is well known for her legislative achievements. Medicaid is a $22 billion enterprise, w/ the State contributing 40% and the Feds 60%. Eliminating the program would result in a 2% decline in GSP and a reduction in future growth, as the health care industry is a rapid growing industry. One would also expect an adverse impact on employment, as health care employment has accounted for a significant proportion of employment growth in the State. Approximately 1.0 million Texans are employment in health care industry. Between 2005 and 2009, employment in health care accounted for 23.5 percent of the 571,000 jobs created in TX. Long term care providers would experience a $5.2 billion reduction in receipts and dispro share hospitals would find $1.5 billion in revenue. Texas would also cement it's place as No. 1 forever in the proportion of its population w/out health insurance as dropping Medicaid would increase the number of Texans w/out health coverage to around 10 million or 40% of its population. Finally, one should recognize that the Medicaid program is really a transfer from the government to medical providers, using the poor as the transmission agent. It will be interesting to see what the reaction of these providers are to the loss of $21 billion in income. I know I'd be mildly upset loosing $21 billion in income.
Susan Kiernan via Texas Tribune on Facebook
Perry - doesn't support the "do gooders" as noted in his election night speech.
S Steinberg
Beyond the cost in human suffering, it's a bad fiscal move. As Scott Chase notes, people without coverage simply go to the emergency room to receive care, where it's far more expensive and far less effective than preventive medicine.
An excellent case in point: In 2007, a 12-year-old Maryland boy, Deamonte Driver, died after an infection from an untreated dental abscess spread to his brain. His mother couldn't find a private dentist who would accept his Medicaid coverage, because reimbursement rates (set by the state) were so low. He underwent two emergency surgeries, which cost the state more than $250,000 -- when a $100 dental visit to treat his tooth at the outset would have prevented the tragedy.
Is Texas willing to spend $2,500 to save $1? I'm afraid we already know the answer.
Sam Hamlett
Wasn't there mention in the last paragraph of the article to replace the Medicaid program with a more cost efficient and better care state run program? That falls in line with Perry's wanting to keep stuff done at the state level instead of having the Feds interfere.
sgre144
Re: Sam Hamlett
"Wasn't there mention in the last paragraph of the article to replace the Medicaid program with a more cost efficient and better care state run program? That falls in line with Perry's wanting to keep stuff done at the state level instead of having the Feds interfere. "
Yes, the Governor would like a more cost efficient and better run program. So, let's assume that this more efficient and better run program reduces Medicaid expenditures by half, from $22 bil. to $11 bil. W/ the better run program, life expectancy in Texas (77 years) increases to the U.S. average (77.4 years). While these would be desirable objectives to obtain, it would still require Texas to increase Medicaid spending from $7 bil to $11 bil, To maintain Medicaid spending at $7 bil (the current state funding) would require eliminating payments for Acute Care, $14.8 bil, leaving just Long Term Care ($5.2 bil) and Dispro ($1.5) to fund.
Sherry Watkins
I may as well curl up and die now. My prescriptions run just about as much as my medicare - how do I pay rent? how do I eat? how do I go to the dr.? on and on and on......Can't work, on disabillity. Can't drive, no car and no transportation will come out here. I give up.