Gov. Rick Perry’s proposal last week to request a Medicaid block grant—without accepting new federal Medicaid funds perceived as an “expansion”—would do little to move the needle on the economic impact of the uninsured in Texas, the Texas Hospital Association said Monday.
Because the proposal neglects to expand coverage through Affordable Care Act-mandated reform, it fails to provide relief to Texas hospitals that are already paying for Medicaid expansion via reimbursement rate cuts, THA said.
“The Texas Hospital Association supports a Texas solution to solving the problem of uninsured, but the existing health insurance market does little to improve the coverage picture or to alleviate the financial burden on hospitals, taxpayers, the privately insured and businesses,” said THA president and CEO Dr. Dan Stultz.
The grant would be a fixed amount of money, rather than matching dollars for Medicaid services, as was the case with the Affordable Care Act provisions. Additionally, Perry requested that HHSC seek a waiver that allows the state to make changes to the program without receiving federal approval and to initiate cost-sharing initiatives.
The waiver “should give Texas the flexibility to transform our program into one that encourages personal responsibility, reduces dependence on the government, reins in program cost growth and efficiently improves coordination of care,” Perry wrote in an email to HSSC executive commissioner Kyle Janek.
Texas continues to lead the nation in the rate of uninsured. According to new U.S. Census data, nearly 6.4 million Texans— 24.6 percent—lack health insurance. Nearly 33 percent of the state’s working-age adults are uninsured. Nationally, the uninsured rate fell to 15.4 percent, from 15.7 percent in 2011, a number that some Census officials have linked to a higher rate of U.S. residents moving over to Medicare.
Higher premiums, higher local taxes, and difficulty attracting companies to Texas are all side effects of having so many uninsured residents, Stultz added.
The availability of subsidized private coverage on Oct. 1 through the health insurance exchanges will begin chipping away at Texas’ uninsured rate, but, in the absence of expanded Medicaid coverage, the exchanges aren’t expected to make as big of a dent as in other states. As a result, hospitals, taxpayers, and the privately insured will continue to shoulder a heavy share of the costs of providing care to the uninsured, Stultz said.