Medicaid is the health lifeline for more than 3 million of the most vulnerable Texans, but some Republicans, including Gov. Rick Perry, are talking about opting out of the program as a massive state budget shortfall looms.
The prospect, described by some as far-fetched, raises fears about the toll on poor children, people with disabilities, pregnant women and the elderly. Medicaid covers at least part of the cost for more than 60 percent of nursing home residents.
Speaker-in-waiting Warren Chisum is here to ally concerns.
Those looking to shake things up said they are not proposing to put existing Medicaid patients out in the cold. They said they want to find a way to deliver health care in a better, more cost-effective way as Texas bends under the burden of more needs than money.
"It's not a warning that we're going to throw momma out of the retirement home, it's just saying we've got to do something different, because this is not working for us," said state Rep. Warren Chisum, R-Pampa, who cited the Medicaid opt-out idea as he runs for House speaker.
Rest assured, the Republicans say there will be no death panels deciding who gets treated and who gets rolled on a gurney out in the street.
With their ability to touch Medicaid hampered by federal requirements and the federal health care law aiming to add to the Medicaid rolls in the future, some fear the impact on areas such as education and public safety.
"It sends a strong message to the federal government that what you've asked the states to do, even with the (funding) matches that you're proposing, is going to cause the states to go bankrupt — or certainly it's going to compromise our ability to deliver on education, public safety and infrastructure," said state Rep. John Zerwas, R-Richmond, an anesthesiologist.
The Texas Health and Human Services Commission is looking at what the effect would be if Medicaid were abolished in Texas or federal matching funds were slashed. Zerwas, who carried the legislation that called for the study, is saying not that he supports an opt-out but that the idea needs to be thoroughly studied, including the human and economic effects.
Details are unclear on what would replace Medicaid if Texas opted out. Groups, including the limited-government Texas Public Policy Foundation, are working on proposals with the idea that the state still would be able to pull down federal funds in addition to its state health care money, or the federal government would otherwise continue coverage options.
"It's not just opting out of Medicaid. It is replacing the Medicaid program with something that is affordable by the states and the federal government and can deliver better care," said the foundation's Arlene Wohlgemuth, a former state lawmaker.
Perry told Fox News that he thinks Texas could find a "private insurance solution" that would save the state and federal government $40 billion each over six years while covering more people. He did not give specifics.
There it is: PerryCare. Which of the governor's richest friends wants to start the company to take Medicaid private? What private insurance company wants to take over coverage of the elderly, the poor, and the infirm? I forget; which ones are now?
Who said elections don't have consequences?
Update: STC has more, including a "superbad" quote from Speaker-to-be Chisum.
Update: STC has more, including a "superbad" quote from Speaker-to-be Chisum.
