Tag Archives: Texas Hospital Association

Growing Support For Texas Medicaid Expansion?

Politicians tend to say a lot of things when on the campaign trail.  They make a barrage of promises to different audiences, trying to court voters at every turn.  The 2014 election was certainly no exception for Greg Abbott, who handily defeated Democratic challenger Wendy Davis just weeks ago.

But sometimes what is not said is just as important in politics.  After a resounding victory, Governor-Elect Abbott, who vowed on the campaign trail to never seek any form of healthcare expansion under the Affordable Care Act, has remained surprisingly silent on the issue as he prepares to lead the state.

Meanwhile the chorus of state leaders supporting a Texas solution to healthcare expansion continues to grow louder by the day, even among persons Abbott has hand-picked for the state’s top administrative offices.  Here’s more from the Texas Tribune

Gov.-elect Greg Abbott’s pick for Texas secretary of state voted for a local resolution last year endorsing the expansion of Medicaid — a central tenet of the federal Affordable Care Act that Abbott fiercely campaigned against.

In a phone interview, Carlos Cascos, a Republican judge from Cameron County, said that as secretary of state he was “not just going to go along to get along” with Abbott, and that on health care issues there would be “policy disagreement” among Republican officials.

Last year, when Cameron County officials endorsed expanding Medicaid, Cascos told NPR, “It’s contrary to what the leadership in Austin is recommending, but we thought it was important enough to take a position.”

On Thursday, Cascos qualified his support for extending Medicaid coverage to more than 1 million low-income Texans, saying, “At the time, I was looking at it from a local perspective in terms of the uninsured we have here in the [Rio Grande] Valley.”

Abbott’s very selection of Cascos seems to suggest that the opinions of RGV Republican leaders are important.  The Secretary Of State Designate’s opinons come on the heals support from another influential group, this time appointed by Governor Rick Perry.  Again, more from the Trib

A board of medical professionals appointed by Gov. Rick Perry said Wednesday that the state should provide health coverage to low-income Texans under the Affordable Care Act — a move the Republican-led Legislature has opposed.

The 15-member Texas Institute of Health Care Quality and Efficiency recommended that the state’s health commissioner be authorized to negotiate a Texas-specific agreement with the federal government to expand health coverage to the poor, “using available federal funds.”

“We’re trying to look at actions whereby more Texans can be covered,” said board chairman Steve Berkowitz, the president and founder 0f SMB Health Consulting. “We’re trying to take the politics out of it.”

As if advocates for Texas citizens themselves were not enough, don’t forget that Texas hospitals, tired of losing billions of dollars to uncompensated care costs, are also facing some tough choices if the state continues to ignore the situation.  This is exactly why the Texas Hospital Association also renewed its call for the legislature to find a Texas solution that helps them, and those seeking medical care.

For Abbott to remain silent when so many groups are speaking out is telling.  Is he listening to the bi-partisan coalition to help Texas families?  Will he change his position on the issue and allow our Texas tax dollars to come back where they belong?  Even if Abbott were to come out in support, what are the chances of finding support withing the legislature, or of Lieutenant Governor Dan Patrick even bringing such an issue to the Senate floor?

The answers to all will be revealed soon, but for now, the best thing Texans can do is keep talking.  At least then, there is a small chance that our voices will be heard as well.

 

(photo credit:  Travel Trip Journey)

2014: New Year, Old Challenges for ACA

Though the tormented roll-out of the Affordable Care Act is still fresh on the minds of most Americans, it’s important to note that the dark days of Obamacare are most likely over. The website is now working fairly smoothly, and people are finding that they are able to access healthcare coverage easier than ever before. And despite copious attempts at disruption, deceit and misinformation, even Texans are finding their way through the process to obtain health insurance. As the Texas Tribune notes, enrollments in the Lone Star State are actually moving as fast as areas that were more amiable to the law…

Texas enrollments in the online insurance marketplace created under the Affordable Care Act rose nearly eightfold in December, according to 2013 figures that the U.S. Department of Health and Human Services released Monday.

Texas ranks third in the number of 2013 enrollments following the troubled launch of healthcare.gov on Oct. 1. As of Dec. 28, nearly 120,000 Texans had purchased coverage in the federal marketplace, up from 14,000 one month before.

The number represents a tiny fraction of the uninsured in Texas, which has a higher percentage of people without health coverage than any other state. In 2012, more than 6 million Texans, about 24 percent of the population, lacked health insurance, according to U.S. census data…

Three-quarters of Texans who purchased health plans in the exchange in 2013 received financial assistance, according to the HHS data. That percentage, which is less than the median rate of 80 percent for the 36 states operating under the federal exchange, might have been larger had Texas expanded Medicaid to cover poor adults. Texans living below the poverty line do not qualify for subsidies.

Granted 120,000 enrollees is still far-short of the 6 million Texans that are in need of coverage, but it’s significant progress nonetheless. Try as they did, Governor Perry and Attorney General Greg Abbott did not destroy Obamacare. It’s in Texas, and it is here to stay.

But who suffers from the Governor and AG’s ACA malice? Texas’ poorest citizens and our hospital system by refusing the state’s Medicaid Expansion. There’s nothing the GOP can do to destroy Obamacre, so they’ve decided to turn their wrath onto their most vulnerable constituents. Directly from the Texas Hospital Association, here’s some insight into the bind that Perry and Abbott have created for the state’s already cash-strapped hospitals…

Unfortunately, the positive impact for Texas hospitals is diminished. The state’s failure to extend Medicaid coverage to the working poor or devise its own solution to reduce the number of uninsured leaves more than one million Texans with no access to affordable coverage options.

In addition, ongoing and new federal funding cuts result in significantly fewer resources for Texas hospitals to provide care for the uninsured.

–Hospitals already provide more than $5 billion annually in uncompensated care because of Texas’ high rate of uninsured.

–Reductions in Medicare Disproportionate Share Hospital payments began in FY 2012 and for FY 2014 alone are between $16 million and $19 million.

–The recent congressional budget deal will extend federal cuts to the Medicaid Disproportionate Share Hospital program that were intended as “pay-fors” for Medicaid expansion for an additional year through 2023.

–The budget deal also extends the two percent sequester reduction in reimbursement rates for Medicare providers (including hospitals) for two additional years from 2021 to 2023.

–The three-month SGR or “doc fix” will avert deep cuts to physician reimbursement but contains substantially lower payments for long-term care hospitals that serve patients with clinically complex conditions.

“Increased private insurance enrollment through the Marketplace is certainly good news, but with a million Texans remaining uninsured and reduced federal resources, Texas hospitals will shoulder a heavy financial burden,” said John Hawkins, THA senior vice president for government relations. “The state’s inaction on coverage for the working poor and new and continued funding cuts at the federal level are a real threat to Texas hospitals’ continued ability to provide the highest quality care to all who need it.”

That $5 billion of uncompensated care?? That’s what I refer to as Crisiscaid… basically the only option for people who have no health insurance. They go along, hoping and praying that everything is ok, but the moment they get sick or have an accident, their only option for treatment is to go to the Emergency Room. And if they don’t have thousands of dollars to pay the hospital for that treatment, the hospital loses money. This a problem statewide, but it puts a particular strain on our state’s rural hospitals… many of which are facing closure if Medicaid is not expanded.

As Greg Abbott stumps around the state for his Gubernatorial bid, he has yet to address the question of how he plans to save Texas’ rural hospitals without taking the Medicaid expansion. For all of these people that no access to health insurance, what does he want them to do? One simple vote by the legislature is all that stands in the way of affordable healthcare for millions of Texans. Hard-working doctors and hospitals would be empowered to care for more patients without worrying so much about their bottom line. erhaps someone should ask him these questions. Hopefully Democrats will find the courage to demand answers soon. 

Texas Health Scare: What’s our alternative?

Now that the Supreme Court has upheld the Patient Protection and Affordable Care Act (you know… Obamacare), states are slowly coming to the inevitable conclusion. It is the LAW. The clock is now ticking for states like Texas to begin implementation of these new provisions of health care.

But don’t be fooled, that particular clock was ticking in Texas a long time ago. As evidenced in a previous post, Obamacare or not, state healthcare costs have been on a meteoric rise between 2005 and 2009, skyrocketing 36% during just those 4 years. Even as the costs for the state continue to mount, the number of Texans without insurance continues to rise as well.

Here are some sobering facts from the Texas Medical Association

1 in 4 Texans are uninsured. That’s over over 6.2 million people as of 2010.

-These uninsured people have no but choice to seek the emergency room. As a result they drive up Healthcare costs for everyone else. The average cost to treat a minor ailment in the Doctors office? $56.21. In the emergency room? $193.92 That’s almost 4 times the expense as it would be going to the doctor for a similar ailment (much less waiting until it becomes WORSE). Guess who absorbs those costs? And Texans wonder why our healthcare costs are soaring.

Only 50% of working Texans have health insurance… 49th in the country. The common misconception here is that employers are supposed to offer some form of a health insurance plan. That wasn’t actually a law until the passage of the Affordable Care Act. As a right-to-work state with a plethora of low-wage jobs, Texas companies have very little incentive to offer health insurance. So contrary to popular belief, it’s not just those on welfare in Texas that are struggling to find health care. It’s many of the employed public too.

In the face of these staggerring statistics, Governor Perry, Attorney General Greg Abbott and the Republican-led Texas legislature have vowed to fight the Affordable Care Act tooth and nail. It’s quite an odd stance too, as many Texas Hospitals are in full support of the Medicaid Expansion. Here is a statement from Dan Stults, President of the Texas Hospital Association

“Texas hospitals recognize there are concerns with expanding the Medicaid population, but given the state’s high number of uninsured, all options for gaining insurance coverage must be closely considered. Under PPACA, a significant number of low income individuals could gain insurance without any cost to the state of Texas for several years. Without the Medicaid expansion, many will remain uninsured, shifting costs to the insured and increasing uncompensated care to health care providers,” said Dan Stultz, M.D., FACP, FACHE, THA president/chief executive officer.

“The law was never meant to fix all the problems facing the health care system,” Stultz said. “Texas hospitals look forward to a continued discussion on how to improve the effects of the law for patients, families and communities.”

So Texas hospitals are all for the expansion of Medicaid, the state funding gap for healthcare is increasing at an alarming rate, and our uninsured continue to tax our emergency rooms, and pass ever-ballooning costs to us Texans that are lucky enough to actually have insurance. But Perry and the boys don’t want any government help from “Obamacare”.

Only one question remains to the Governor. What is your alternative?? You continue to reject implementation of the new law, but how would you propose that Texas solve these problems? Are our good Texas companies going to have a change of heart and start insuring all of their workers? Maybe they’ll be nice enough to donate directly to the hospitals so the uninsured can get treated at the ER “for free”? Maybe all of our aging Baby-Boomers will get fed-up and move to Florida??

All Texans should be asking Governor Perry and state lawmakers these questions. If our state really does decide to opt-out we need a real plan in place, and it needs to get implemented now. Mr. Perry… Time’s up.