Tribpedia: Medicaid

Fat and Skinny

That steady drip, drip, drip in the biennial Scare the Speaker thing has been plugged for the moment. Scratching around for other amusements, we came upon a congressional map for Texas showing who's got too few and too many people in their congressional districts.

TribWeek: In Case You Missed It

Galbraith on wood chips and green energy, Aguilar on why conservatives might get the appeal of medical marijuana, Philpott on an effort to uncloak the hidden costs of government, Ramshaw and Galewitz of Kaiser Health News on federal plans to send less money to Texas for Medicaid, Aaronson visualizes who's currently covered by Medicaid and how the billions are spent, E. Smith's interview on higher ed and the "speaker drama" with Dan Branch, Hamilton on the costs of a losing football season, Grissom on Hispanic farmers' reaction to a federal settlement in a widespread discrimination case, Hu on what's ahead for Democratic legislators after an electoral drubbing, Chang on the rise of hepatitis B among Asian-Americans and M. Smith on the cuts likely for Texas classrooms in the wake of a record budget shortfall: The best of our best from Dec. 6 to 10, 2010.

Interactive: Medicaid Caseload

It's Texas Medicaid's time in the limelight: Federal health care reform calls for expanding it, some Republicans are angling to bag it altogether and lawmakers are gearing up for a tense debate over broadening the reach of cost-cutting managed care plans. Often lost in these conversations are the people Medicaid served and the money Texas pays to cover them. Our interactive allows you to visualize the 3 million Texans covered and the roughly $6 billion that the state spends.
Patients are shown checking out in 2010 at the People's Community Clinic in Austin, a safety-net clinic that serves Medicaid recipients and the underinsured.
Patients are shown checking out in 2010 at the People's Community Clinic in Austin, a safety-net clinic that serves Medicaid recipients and the underinsured.

Matching Medicaid

Already facing a record budget shortfall, Texas has received more bad news: The portion of state Medicaid costs paid by the federal government is about to drop. Texas’ Federal Medical Assistance Percentage, a mathematical formula linked to a state's per-capita personal income, will fall more than 2 percentage points in late 2011, equivalent to a $1.2 billion hit. Only two states — Louisiana and North Dakota — will face a bigger percentage drop. And that’s after federal stimulus funds that have been artificially enhancing this match dry up in the spring, another blow to cash-strapped state Medicaid programs in Texas and across the nation.

Drama Club

Maybe Dan Branch is right. Asked whether there's a race for speaker, he called it more of a "Speaker Drama" and said Joe Straus (to whom he's pledged) appears to have the thing locked up.

Diabetic Shock

The number of adult Texans with diabetes is expected to quadruple over the next three decades, a massive spike that demographers and health care experts attribute to the state’s aging population and obesity epidemic.

State Representative Jim Pitts, representing District 10. District 10 includes Ellis County and Hill County, Texas.
State Representative Jim Pitts, representing District 10. District 10 includes Ellis County and Hill County, Texas.

There Will Be Blood

Ask House Appropriations Committee Chairman Jim Pitts, R-Waxahachie, and he'll tell you: The budget he and his fellow finance types will put forward in a few weeks confirms fears that carnage is looming. "We're making huge cuts," he told a Tea Party group last week.

Health care assistant Crystal Kreig plays a card game with Steve Parker (center) and Eulalio Alvarada (right) at a group home operated by D&S Residential, Inc. Companies like D&S used to handle case management for their clients, but a budget change sent that responsibility to local Mental Retardation Authorities.
Health care assistant Crystal Kreig plays a card game with Steve Parker (center) and Eulalio Alvarada (right) at a group home operated by D&S Residential, Inc. Companies like D&S used to handle case management for their clients, but a budget change sent that responsibility to local Mental Retardation Authorities.

A Conflict in Care?

For years, the state paid private providers who care for people with disabilities to handle their clients’ case management. But an 11th-hour change inserted into the budget last session stripped them of that responsibility, giving it instead to quasi-governmental Mental Retardation Authorities — and potentially creating a conflict of interest.

Tom DeLay, shown after his trial in 2011. DeLay, who was convicted of conspiracy and money-laundering, was found innocent of all charges by the Texas Court of Criminal Appeals in 2014.
Tom DeLay, shown after his trial in 2011. DeLay, who was convicted of conspiracy and money-laundering, was found innocent of all charges by the Texas Court of Criminal Appeals in 2014.

Tom DeLay Wins!

Yes, a jury convicted the former U.S. House majority leader of money laundering. But his maps — the ones that upended the careers of Democrats and helped the GOP take over Congress — are still in place. No amount of jail time can change that.

Jim Pitts (R-Waxahachie)
Jim Pitts (R-Waxahachie)

TribBlog: Pitts Sees Deep Cuts Ahead

State budget writers will propose eliminating agencies, cutting others to a quarter of their current size and mandating furloughs for state employees to balance the budget without raising taxes or using the state's Rainy Day Fund, Appropriations Chairman Jim Pitts told a hometown crowd.

Drip, Drip, Drip

You know the home inspector told you to fix that leak but hey it wasn't a flood or a lot of water and everything seemed okay and you let it go and now the insurance company is slow-paying and the contractor is shaking his head and your wallet and this is really a painful way to run a race for speaker... Joe Straus hasn't had a really good news day since the Republicans won 99 seats on Election Night and he announced the next day that more than four out of five House members wanted him back.

TribWeek: In Case You Missed It

Hu on the Perry-Bush rift, Ramshaw on the adult diaper wars, Ramsey's interview with conservative budget-slasher Arlene Wohlgemuth, Galbraith on the legislature's water agenda (maybe), M. Smith on Don McLeroy's last stand (maybe), Philpott on the end of earmarks (maybe), Hamilton on the merger of the Higher Education Coordinating Board and the Texas Education Agency (maybe), Aguilar on Mexicans seeking refuge from drug violence, Grissom on inadequate health care in county jails and my conversation with Houston Mayor Annise Parker: The best of our best from November 15 to 19, 2010.

Arlene Wohlgemuth: The TT Interview

The former budget-slashing Texas House member and current executive director of the Texas Public Policy Foundation on how she reads the mood out there, what reductions in state spending should be on the table, whether cost-shifting to local school districts is a plausible option, why lawmakers should forget about new sources of revenue, the trouble with Medicaid and what members of the Republican near-supermajority in the Legislature must do to keep the confidence of voters — and get re-elected.

TribWeek: In Case You Missed It

Galbraith on energy conservation and basketball, Ramshaw (and Serafini of Kaiser News) on what would happen if states abandoned Medicaid, Hallman on cities and counties lobbying the feds (and a Stiles data app visualizing what they're spending), Aguilar on legislative attempts to stop human trafficking, Aaronson on cuts in Senate office spending, Philpott on the latest run at a Senate rule that empowers political minorities, yours truly on how the GOP landslide will change the way things work at the Capitol, Hu catches the first day of bill filing and finds immigration at the top of the agenda and Hamilton on a wobbly partnership between two Texas universities: The best of our best from November 8 to 12, 2010.

The waiting room at People's Community Clinic in Austin, TX in November 2010.
The waiting room at People's Community Clinic in Austin, TX in November 2010.

The Opt-Out Option

A week after newly emboldened Republicans in the Texas Legislature floated a radical cost-saving proposal — withdrawing from the federal Medicaid program — health care experts, economists and think tanks are trying to determine just how possible it would be. The answer? It’s complicated. But it’s not stopping nearly a dozen other states, frantic over budget shortfalls and anticipating new costs from federal health care reform, from exploring something that was, until recently, unthinkable.

No More Medicaid?

Some Republican lawmakers are proposing an unprecedented solution to the state’s massive budget shortfall: opting out of the federal Medicaid program. But experts say the rhetoric may be more of a middle finger to Washington than sound public policy.

Election Days

Twice as many people showed up for the first three days of early voting in the state's top 15 counties as came out four years ago, according to the Texas Secretary of State. Through the end of the day Wednesday (there's a lag in the reporting and those were the latest numbers as we published), 435,007 people had voted, compared with 219,436 four years ago. As a percentage of registered voters, that's 5.22 percent this year as opposed to 2.7 percent four years ago. Early voting continues for another week. During the 2006 gubernatorial election, 13.2 percent of the registered voters in those top 15 counties voted early.

TribWeek: In Case You Missed It

Hu on freshman House Democrats trying to win re-election in a Republican year, Grissom on Republicans bolstered by those same political trends, Aguilar on slow reforms in immigrant detention programs, Chang on the trouble with synthetic marijuana, Ramshaw on how proposed cuts in state Medicaid services could affect 13,000 Texans, yours truly on how political polls have as much to do with who's counted as with what they say, Galbraith on why Texas is building coal plants in spite of tightening federal air pollution standards, Hamilton on community colleges accusing the University of Texas of siphoning money from their financial wells, M. Smith on the court of inquiry proposed for a death penalty case and how it would work, and E. Smith interviews U.S. Rep. Michael Burgess about federal health care: The best of our best from Oct. 11 to 15, 2010.

Barbara Cullison does her daughter Audrey's hair. Audrey, who is autistic, risks losing her Medicaid waiver services because of state budget cuts.
Barbara Cullison does her daughter Audrey's hair. Audrey, who is autistic, risks losing her Medicaid waiver services because of state budget cuts.

A Hole in the Safety Net

Advocates say the Department of Aging and Disability Services’ baseline budget request eliminates financing for more than 13,000 people — the majority waiting to receive Medicaid waiver services. Agency officials will only say that an “unknown number” of people already receiving the services could lose them. It's unclear if lawmakers can make these cuts without risking losing federal funding; federal health care reform requires states to maintain coverage at the same level it was when the Affordable Care Act became law in March.

Clay Boatright, the new president of the Arc of Texas
Clay Boatright, the new president of the Arc of Texas

Clay Boatright: The TT Interview

The new president of the Arc of Texas on why the disability community’s rallying cry to close state-supported living centers has become trite and ineffective, why the movement's messaging should be upgraded (employing everything from the iPad to the Bible) and why businesses and faith-based groups should be mobilized to fill the gaping holes in government services.

In the Soup?

Double-billing taxpayers for travel expenses, driving a luxury car owned by a state transportation contractor and repeatedly failing to pay taxes won’t put a lawmaker in good standing with the ethics police, as state Reps. Charles “Doc” Anderson, R-Waco; Joe Driver, R-Garland; and Linda Harper-Brown, R-Irving, are finding. The three hope the headlines dogging their re-election bids won’t follow them to the polls, while their Democratic opponents are reveling in their misery at every campaign stop. Yet whether a scandal forces an incumbent from office depends on the scenario.