Last month, Texas lawmakers released a proposed budget that would reduce Medicaid reimbursement rates by 10 percent. Rates are being reduced to the point that Texas have threatened to withdraw from the program altogether.
The Dallas Morning News reports that budget writers are grappling with potential unintended consequences while figuring out which services to cut. For instance, cutting kidney dialysis treatment may cause an increase in hospital patients with severe renal disease. An excerpt:
Medicaid, a state-federal program, covers poor children, pregnant women, disabled adults and the elderly in nursing homes. Texas’ GOP leaders have proposed cuts of 29 percent, a much larger reduction than most programs would see as lawmakers try to write a balanced budget without raising taxes or exhausting their rainy-day money.
The program’s price tag grew rapidly in the current two-year cycle because Congress temporarily enhanced federal matching money to help recession-ravaged states cope with swelling rolls. But now, GOP leaders say, the beast must be tamed.
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While a huge share of the cuts will come out of care providers’ fees, there are figures pulled out of the air for new efficiencies, savings generated by new outcomes-based payment models and cuts to the adult recipients’ so-called optional services. Details are to come later.
Lawmakers face a dilemma. Cutting Medicaid services to save money may cause patients to delay treatment and, at the same time, cause physicians to stop taking Medicaid patients.
A related story on Politico suggests home care may lessen the sting of some service reductions. For patients in nursing facilities who don’t need round-the-clock care, home care is a less expensive option.