Sunday, April 17, 2011

Adding to Medicaid Emergency

In addition to $121 million in projected Medicaid cuts for the Concho Valley, the Texas Legislature may require copayments for selected people on medical assistance, i.e. Medicaid--the health insurance program for the poor  Fees include an enrollment charge, deductible and copays for a wide variety of services, including a $15 copay for emergency room services vs. a $5 copay for a doctor visit..

Legislative staff predicted the cost to implement copays and savings to the state from HB 2368.  Costs are the red bar, while savings are green.

The state of Texas will spend $12.9 million to save $1.2 million over a five year period.  Hospital and clinic staff will spend time trying to collect Medicaid copays, billing, tracking, followup etc.

Why would legislators push a project with an overwhelmingly negative (-91%) return on investment?  They expect a different return.  Texas' Children's Health Insurance Program (CHIP) history shows kids tumbling from the rolls, due to increased cost sharing and stricter eligibility requirements.  The number of CHIP covered kids in Tom Green County fell by half due to the 2003 Texas Legislature. 

At Bishop Pfiefer's Lady Justice meeting, Rep. Drew Darby indicated the general trend would have the legislature putting more responsibility on the individual.  He didn't say if elected officials expected a similar shedding of people from Medicaid or CHIP rolls or how that might implode safety net hospitals like Shannon Medical Center.

While fires burn around San Angelo, the Legislature looks to scorch our health care landscape.

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