Tribpedia: Medicaid

Facing Budget Cuts, Texas Agency Chiefs Stay Calm

HHSC Commissioner Tom Suehs testifies before lawmakers.
HHSC Commissioner Tom Suehs testifies before lawmakers.

They’re surely facing the worst budget cycle any of them have experienced. Yet in hours of testimony before lawmakers — flanked by the school children and people with disabilities who will be hit hardest by the cuts — the commissioners of Texas’ social services and education agencies appear largely unruffled. Critics say it’s because the agency chiefs are being “good soldiers,” appointed by a Republican governor determined to meet the budget shortfall without new revenue.

Texas Budget Cuts Trickle Down to Local Governments

One lawmaker has proposed a constitutional amendment blocking lawmakers from passing so-called unfunded mandates on to local governments. But as Ben Philpott of KUT News and the Tribune reports, with billions of dollars set to be slashed from the state budget in the coming months, cities, counties and other local governmental bodies worry the costs will come anyway.

Gov. Rick Perry delivering his State of the State address on Feb. 8, 2011
Gov. Rick Perry delivering his State of the State address on Feb. 8, 2011

Rick Perry at CPAC: Local Government Governs Best

In a rock concert-like setting, at times reaching near Howard Dean-like volumes, Gov. Rick Perry used his speech at the Conservative Political Action Conference in Washington to deliver his resounding message: The government closest to the people is the one that governs best.

Gov. Rick Perry's Symbolic Cuts and His Real Ones

If you’re going to make a bunch of people mad, you should make sure you’re getting something for it. The proposed budget cuts Gov. Rick Perry laid out in his State of the State speech — defunding the states arts and historical commissions, for example — are more symbolic than lucrative and trivialize the cuts that are being made elsewhere in state services and programs.

Dr. Xavier Muñoz treats a patient in El Paso. Muñoz agreed to treat low-income, underinsured patients in return for having his medical school bill repaid — a program that could be eliminated through state budget cuts.
Dr. Xavier Muñoz treats a patient in El Paso. Muñoz agreed to treat low-income, underinsured patients in return for having his medical school bill repaid — a program that could be eliminated through state budget cuts.

Texas Physician Loan Repayment Deal in Jeopardy

More than 100 Texas doctors made a deal with the state: For four years, they would practice in underserved communities and treat the neediest patients — in return for having their med school debt forgiven. The source of the funding? A tax on smokeless tobacco. But just a year into the arrangement, and facing a multibillion-dollar shortfall, state officials may be backing down from their side of the bargain, and using the smokeless tobacco revenue to balance the budget instead.

Word cloud aggregate of Rick Perry's State of the State speeches from 2001 to 2009.
Word cloud aggregate of Rick Perry's State of the State speeches from 2001 to 2009.

Perry to Push Texas Colleges to Offer $10,000 Degree

Gov. Rick Perry will deliver his sixth State of the State speech later this morning, challenging the state's colleges and universities to offer a $10,000 bachelor's degree, including books. The higher education proposal is part of a call for a streamlined and more efficient state budget; Perry will try to sell the state's fiscal troubles as an opportunity to reshape the government.

Bill Hammond is the CEO of the Texas Association of Business.
Bill Hammond is the CEO of the Texas Association of Business.

Hammond: No Time to Be Penny-Wise, Pound-Foolish

We must continue to fight to ensure that we implement cost-saving reforms that reflect Texas' commitment to prosperity and to economic growth. But our current budget shortfall isn't a time to be penny-wise and pound-foolish.

Former state Rep. Talmadge Heflin is the director of the Texas Public Policy Foundation’s Center for Fiscal Policy.
Former state Rep. Talmadge Heflin is the director of the Texas Public Policy Foundation’s Center for Fiscal Policy.

Heflin: Most Sensible Solution Is Reduced Spending

More money is not the answer to our current woes. Just as anyone managing a household budget knows, when a family’s expenses grow beyond its income, the solution is to cut back — particularly if its spending habits resemble the state's.

Pretty Good Forecasting

Texas Weekly

The keepers of numbers over in the LBJ Building, north of the Capitol, have confirmed to lawmakers what they warned them about in 2006: The legislation that cut local school property taxes and revised the state's corporate franchise tax didn't balance, to the tune of $10 billion a biennium.

TribWeek: In Case You Missed It

Hamilton on saving small towns with culture, E. Smith's interview with Senate candidate Michael Williams, Grissom on budget writers killing a program but keeping the fee that pays for it, Galbraith on the anniversary of the Texas secession fight, M. Smith on what's protected from public school budget cuts, Aguilar on efforts to catch illegal immigrants where they work, and Ramshaw on adopted kids who end up on the same watch lists as the people who abuse them: The best of our best from January 31 to February 4.

A coalition of Tea Party groups rally against President Obama on Jan. 16, 2009, at the Texas Capitol.
A coalition of Tea Party groups rally against President Obama on Jan. 16, 2009, at the Texas Capitol.

Texas Won't Secede — But It Won't Shut Up Either

Texas leaders aren't talking about secession, after an outbreak of conversation about it a couple of years ago. But the germ of the idea remains in the anti-federalist talking points that fueled Gov. Rick Perry’s re-election campaign last year and provided the outline for his book, “Fed Up!” The governor will make his State of the State speech to the Legislature next week, and attacking the power of the federal government is likely to be a central theme.

Disabled man outside room where Senate Finance Committee listens to testimony on February 2, 2011
Disabled man outside room where Senate Finance Committee listens to testimony on February 2, 2011

Health Care Advocates Offer Emotional Pleas

From patients and parents to nurses and practitioners, the many faces of Texans affected by health care budget cuts gathered at the Capitol today to give an earful to lawmakers on the Senate Finance Committee. The onslaught of emotional testimony appeared to affect some senators. “I’ve never seen the [level of] concern by your presence today," said state Sen. John Whitmire, the Houston Democrat who has argued against such sweeping cuts. "It will make a difference."

Odiel Rodriguez, a physician assistant, checks a patient's file at Ashley Pediatrics Day and Night Clinic in Pharr. Family practitioners fear what budget cuts will mean for the funding that keeps them in business.
Odiel Rodriguez, a physician assistant, checks a patient's file at Ashley Pediatrics Day and Night Clinic in Pharr. Family practitioners fear what budget cuts will mean for the funding that keeps them in business.

Are Payment Reform, Texas Budget in Conflict?

Call it a primary care conundrum. On one hand, lawmakers are crafting legislation to make health care more affordable and effective, through a series of programs to reward doctors and health care providers who get the best medical outcomes. On the other, they’re proposing meeting the state’s budget crunch by slashing Medicaid provider rates and eliminating funding for family practice medical residents — the same workforce they’re relying on to implement key parts of their reform.  

David Dewhurst: The TT Interview

The lieutenant governor believes he knows how to save Texas money and improve patient care by overhauling how doctors and hospitals are paid: with carrots, not sticks. In an interview with the Tribune, he talks about what he sees as the root of the state's — and the country's — health care crisis and how his proposed solutions are nothing like federal health reform.

HHSC Commissioner Tom Suehs testifies before lawmakers.
HHSC Commissioner Tom Suehs testifies before lawmakers.

Suehs Warns Lawmakers on Health Cuts

Health and Human Services Commissioner Tom Suehs pulled no punches when he warned Senate lawmakers today what proposed budget cuts will mean: either cutting the number of people served, or the money paid to those who care for them.  

TribWeek: Top Texas News for the Week of Jan. 24, 2011

Grissom on what happens — and doesn't — when police don't analyze evidence taken from rape victims, Dehn with video highlights of the Senate debate over photo voter ID, Aguilar on the more than three dozen immigration-related bills waiting for attention in the Legislature, M. Smith on what to do with empty school buildings, Ramshaw on what will happen to hospitals if Medicaid managed care is expanded, C. Smith on how the state's budget cuts could affect churches and other faith-based organizations, Philpott's report for the Trib and KUT News on how the tight state budget could affect mental health care, yours truly on why the initial budget proposal isn't really a plan for state spending, Stiles with a searchable database of the latest campaign finance reports, and Galbraith on the rising use of coal and wind to generate electricity in Texas: The best of our best from January 24 to 28, 2011.

State Rep. John Zerwas, R-Simonton
State Rep. John Zerwas, R-Simonton

John Zerwas: The TT Interview

The state representative and anesthesiologist from Simonton on why he filed the House's first bill to implement a key piece of federal health-care reform and was the first in his party to openly suggest that dropping out of Medicaid wasn't such a great idea after all. 

Imam Islam Mossad of the North Austin Muslim Community Center recites the Islamic call to prayer to start Texas Impact's interfaith prayer service on the capitol steps on the first day of session. Members of Christian, Muslim and Jewish faith traditions gathered to pray for legislators and to ask that they act as responsible shepherds for the people of Texas.
Imam Islam Mossad of the North Austin Muslim Community Center recites the Islamic call to prayer to start Texas Impact's interfaith prayer service on the capitol steps on the first day of session. Members of Christian, Muslim and Jewish faith traditions gathered to pray for legislators and to ask that they act as responsible shepherds for the people of Texas.

Faith-Based Groups Brace for Brutal Budget Cuts

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Like many other Texas groups, faith organizations that lobby lawmakers are bracing for a brutal budgetary session. It’s not only a moral issue for the religious groups; it concerns their own bottom lines, too. Because when the government doesn’t provide for the needy, the needy look to the church.

Dr. Carlos Cardenas, chairman of the board at Doctor’s Hospital at Renaissance in Edinburg, performs an exam on a patient on Wednesday December 8, 2010. Many Texas hospitals like this one oppose certain aspects of the proposed expansion of Medicaid managed care.
Dr. Carlos Cardenas, chairman of the board at Doctor’s Hospital at Renaissance in Edinburg, performs an exam on a patient on Wednesday December 8, 2010. Many Texas hospitals like this one oppose certain aspects of the proposed expansion of Medicaid managed care.

Texas Hospitals Could Face Cuts in Federal Funds

Texas hospital administrators aren't thrilled about the 10 percent Medicaid provider rate cut included in the House's proposed budget. But what they fear more is the proposed expansion of Medicaid managed care, which could force them to forgo a combined $1 billion a year in federal funding.

State Rep. Jim Pitts, R-Waxahachie, lays out House Bill 1.
State Rep. Jim Pitts, R-Waxahachie, lays out House Bill 1.

More a Call to Arms Than a Budget

Whatever budget lawmakers eventually approve will serve as the working blueprint for the state for the two years starting in September. But the budget released last week isn’t a blueprint — it’s a political document. It marks the shift from the theoretical rhetoric of the campaigns to the reality of government.

Pick Your Poison

Texas Weekly

In the House, it's the nastiest, ugliest budget anybody's seen in a zillion years. In the Senate, they'll start on Monday with voter ID, the issue that froze the Legislature two years ago.

Residents of East Texas, and particularly minorities, often make lifestyle choices, like smoking and eating high-fat diets, that affect their life expectancy.
Residents of East Texas, and particularly minorities, often make lifestyle choices, like smoking and eating high-fat diets, that affect their life expectancy.

Bad Diets, Smoking Cause East Texans to Die Young

The proof of East Texas' live-hard, die-young culture is in the bread pudding — and the all-you-can-eat fried catfish, the drive-through tobacco barns and the doughnut shops by the dozen. In a community where heavy eating and chain smoking are a way of life, where poverty, hard-headedness and even suspicion hinder access to basic health care, residents die at an average age of 73, or seven years earlier than the longest-living Texans, according to a preliminary county-by-county analysis by the University of Washington Institute for Health Metrics and Evaluation.