Texas cannot walk away from Medicaid, and Gov. Rick Perry agrees, Health and Human Services Commissioner Tom Suehs said this afternoon, hours after releasing the agency’s long-awaited report on the feasibility of dropping out of the federal matching program.
“He knows he can’t walk away leaving 15 percent of the health care economy on the table,” Suehs said in an interview with the Tribune. “But he also knows he can’t continue the program the way it is today, and we have to work with Congress to reinvent it.”
Perry answered for himself in a press release, calling the current Medicaid system "financially unsustainable for states and the federal government."
“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," Perry said. "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.”
Suehs hopes the feds will be inspired to act because they’re hearing the same message from states across the country: “You can’t sustain the growth rate of the Medicaid program with the current restrictions and parameters.” He said all the talk about opting out should really be talk about reinventing Medicaid — changing the fundamentals of the system to give states more flexibility.
“Whether you’re in Medicaid or you opt out of Medicaid, your debate is fundamentally the same. What does our safety net health care system look like, how are we going to deliver it, and how are we going to pay for it?” Suehs said. “And whether you’re in Medicaid or out of Medicaid, if you want savings, you have to reduce the number of people you serve. And that’s not a pleasant exercise.”
Suehs acknowledged that some earlier estimates about the cost of federal health care reform might have been a little high — mostly because they included estimates that hospital systems would lose large sums of federal uncompensated care funding. “We recognize we may have overstated,” Suehs said.
If the federal government decides health care reform will extend insurance subsidies to impoverished adults — something that’s possible but doesn’t appear likely — it would change the estimates significantly, Suehs said.
“We would determine that there would be savings” from dropping Medicaid, he said.
Suehs said he believes there’s enough money in the health care system to cover everyone who needs it, but said that currently these dollars are being used inefficiently.
“No matter what I do, I’ll have 90 percent of people mad at me,” Suehs said, joking that he’d rather be operating Medicaid in a less complicated place, “like Wyoming.”
“We’ve got to change the system,” he said, "and I don’t want to do it at the expense of throwing people out who need care.”