As I posted on Facebook the other day there is a lot of stupid and mean going on in Austin these days. It seems that Governor elect Abbott is just as stubborn and as recklessly spiteful as former Governor Rick Perry. Greg Abbott is on the same cruel mission to punish the poor as hard as possible. Knowing the data and the facts that support expanding federally funded Medicaid would provide health care for millions of uninsured Texans. These are folks who cannot afford Obamacare and are not poor enough to qualify for Medicaid, as it stands in Texas today.
Greg Abbott doesn't care. The fight between Texas and the federal government over Medicaid threatens the $4 billion safety net.
Texas stands to lose some $4 billion in annual funding to care for the poor unless it can persuade federal authorities to renew a Medicaid waiver due to expire in September 2016.
But federal officials signaled last week they may no longer be willing to pay for uncompensated care for people who could be covered by expanding Medicaid under the Affordable Care Act. With Texas lawmakers adamantly opposed to a Medicaid expansion, the waiver expiration creates a potential showdown between state and federal health care officials that, if not resolved, threatens to unravel the state's health care safety net.
"It would be a disaster," said Dr. Paul Klotman, president and CEO of Baylor College of Medicine, which provides staffing to Ben Taub, the largest charity hospital in Houston. "I would not be surprised if safety net hospitals just folded."
Great. Close the charity hospitals and let poor and sick people just drop dead. FL Rep. Alan Grayson wasn't kidding when he stated the GOP health care plan. Don't get sick. If you do get sick, die quickly. That certainly seems to be the plan in GOP Texas.
Texas Republicans want the federal funding for Medicaid with no strings. They want the funding in the form of block grants. But the feds don't trust states like Texas with block grants. Republicans here cannot be trusted to use the funding for its intended purposes. In the past Rick Perry used federal funding meant for education to plug some of the state's budget holes in 2011.
Greg Abbott's stalwart malevolence will end up shooting us all in the foot.
The Texas Hospital Association said it supports the renewal of the waiver but would like to see the state provide insurance coverage to indigent patients rather than relying on uncompensated care funding schemes. That would allow patients to see doctors on a timely basis and avoid allowing problems to escalate until they have no choice but to seek much more costly care at the emergency room.
"We would actually prefer some of these innovations that other states have used that are private market," said John Hawkins, senior vice president of government relations for the hospital group. "Those private market solutions we think are better for the beneficiaries, and they're certainly better for providers because we're not trapped in the kind of low reimbursement setting of Medicaid."
Hawkins said even with the waiver, Texas hospitals face a $2.8 billion shortfall in uncompensated care funding for 2016. Without a waiver renewal or Medicaid expansion, that amount could reach $6.6 billion in 2017. Those costs are then shifted to patients with insurance, raising costs for everyone. Moreover, if county hospital districts experience a drastic reduction in funding from Medicaid, they may have to pursue increases in property taxes to make up the difference.
"No Texan is being benefitted by this stance that our state legislators are taking," Klotman said. "We're just shooting ourselves in the foot. It's just unbelievable that a political stance would end up actually doing harm and providing less care to people in our own state. It makes no sense."
But Greg Abbott seems OK with throwing poor Texans into an early death.
The uncertain future of the waiver also threatens some 1,500 projects throughout the state aimed at expanding access to care and providing services in underserved areas. Projects in region 3, which includes Harris County and eight other counties, received $2.2 billion through the wavier over the past five years. That has funded nine new facilities in Harris County providing more than 300,000 primary care visits, and expanding access to behavioral health and dental services for low-income Texans.
"We will not have the resources to provide care to these people," said Dr. Ericka Brown, executive vice president of ambulatory care services for Harris Health. "If we do not continue the waiver, if we do not accept Medicaid expansion, where will these people go? The cost of health care certainly will rise, because we will roll back to the ages of emergency room care, which is absolutely not the right thing to do."
Houston, the nation's fourth largest city, is in Harris Co.
After the 2014 election when the tea party Republicans swept the state a fellow volunteer at the Harris Co. Democratic Party told me voters won't get what they did to themselves until individuals are directly impacted by the mean and stupid that's coming out of Austin.
Greg Abbott and the Texas GOP's spiteful and shortsighted stand to refuse to expand Medicaid could very likely kick us all in the wallets, in one form or another.
The impact could extend far beyond the safety net hospitals as well.
"Removing almost $4 billion from the health care economy of Texas would have significant repercussions," Millwee said. "It's likely that hospital bond ratings would suffer, the ability for Texas hospitals to obtain loans to finance new ventures would be impacted and it's likely that some hospitals would need to reduce services, potentially lay off employees and, in extreme cases, close."
But guess who gets stuck with the bill when Republican lawmakers decide to be
mean and stupid?
You and me.
AUSTIN — Texas’ refusal to expand Medicaid will cause private health insurance premiums to rise by an average of 9.3 percent for people who buy their own coverage, a new study finds.
So when voters wonder why their insurance premiums are more expensive than those of their relatives and friends in other states, one might look to their "representatives" in Austin.
And when our property taxes go up although Lt. Gov. Dan Patrick swears he will lower our taxes, it should come as no surprise.
We roughly have four million people in Texas who are uninsured. That number would be cut in half if we participated in Medicaid expansion,” Dr. Rohack said.
With no federal funding, State Rep. Charles “Doc” Anderson, R-Waco, says the people of Texas could get stuck with paying for uninsured visits.
“This will affect everybody, the hospitals, the patients, taxpayers, everyone,” Anderson said.
“This is a very serious problem and we’re working to find a solution here in Austin.”
Rohack says hospitals in Texas could look to the wallets of taxpayers to help pay for uninsured visits.
Public hospitals can cover uninsured visits by raising property taxes. Private hospitals might negotiate higher premiums with health insurance companies to cover the cost of uninsured visits.
Until Texas works out a Medicaid solution, Rohack says prepare for both to happen.
“If you're in an area with a public hospital, that hospital gets funding through a hospital district, and hospital districts get funding through property taxes and those could go up," Dr. Rohack said.
"If I don't live in a property tax district, private hospitals may push health insurance companies to make me pay higher health insurance premiums for that cost shift."
Obamacare is not the bogeyman here folks. It's our elected ideologically driven "leaders" in Austin that are making irresponsible decisions that will hurt more than help us. So while Lt. Gov. Dan Patrick
whines about getting picked on by the Governor and House Speaker, the Tea Party Lt. Governor and his crew might want to stop picking on us by refusing to see the light on federally expanded Medicare.
But don't be too hopeful, folks. Right now the boys in Austin are too busy flapping their feathers and playing politics, as usual, instead of doing their jobs.
