Medicaid

Veronica Zaragovia/KUT

We don’t often hear about the Medicaid 1115 waiver in Texas, but this waiver gives Texas billions of federal dollars to provide some pretty expensive care.

This waiver expires in 2016, though. Texas is in the process of asking the federal government to extend and renew the money, but that renewal isn't guaranteed.

Nathan Bernier/KUT

A waiver program that provides billions of dollars for Texas hospitals expires next year, and a panel of House lawmakers is asking state health officials if they have a Plan B. 

The 1115 Medicaid transformation waiver, among other things, gives billions in federal dollars to Texas hospitals that provide care for patients who don't have health insurance.  

In 2013, Texas spent almost $4 billion in what's called "uncompensated care" for low-income Texans.

Veronica Zaragovia/KUT News

At the Capitol Wednesday, advocates for people with disabilities showed up in force to draw attention to how much home care attendants earn, which isn't much more than minimum wage.

The chants were hard to ignore at the rotunda. Home care attendants came to ask Texas lawmakers to raise their minimum wage, since in the state, caregivers get a minimum of $7.86 an hour.

At the rotunda, Sarah Watkins, who is in a wheelchair, said she has a tough time keeping a caregiver for long.

Veronica Zaragovia/KUT

Leaders of the Texas Senate have sent a letter to President Barack Obama [read a PDF of the letter here] about Medicaid. It says that if Texas can’t make changes to how it runs Medicaid now, there’ll be no Medicaid expansion for Texas in the future.

The Affordable Care Act gives states the option to expand Medicaid to cover more people, or in the case of Texas and some other states, not expand it.

Veronica Zaragovia/KUT

Texas has the highest rate of uninsured people in the nation, and last legislative session, lawmakers did have some discussion on how Texas could draw down federal dollars to insure more people, but only if the options don't include expanding Medicaid under the Affordable Care Act.

At least one of the bills filed already would allow Medicaid expansion, but that doesn’t mean any will make it to the floor of the House or Senate for discussion.

Veronica Zaragovia/KUT

Texas has Medicaid programs that help parents or guardians care at home for children who would otherwise be eligible for nursing facility care, but recently the requirements for children to qualify for some programs have changed.

Filipa Rodrigues for KUT News

Ahead of the next legislative session, state senators are talking about one of the most politically divisive federal programs – Medicaid. Or more specifically, how to avoid expanding Medicaid eligibility in Texas and still get more people insured.

Under the Affordable Care Act, Texas has at least two options for insuring more people. One is expanding Medicaid eligibility in Texas. The state’s Republican leadership doesn’t support that option.

photo illustration by: Peter Skadberg/Todd Wiseman

Texas is “ultimately responsible” for millions of misspent Medicaid dollars, according to a new federal audit, because a state agency failed to properly oversee the contractor that reviewed the medical necessity of Medicaid claims.

Todd Wiseman, Texas Tribune

Governor Perry’s decision not to accept federal expansion of Medicaid in Texas means 687,000 women will be left in a "coverage gap," according to a report by the National Women’s Law Center. Those women are too poor to qualify for Medicaid, but don’t make enough money to be eligible for subsidies on the federal health insurance exchange. 

Medicaid eligibility standards in Texas are among the strictest in the nation. A parent in a family of three must make less than $3,737 annually to qualify (19 percent of the federal poverty level), according to the Kaiser Family Foundation. Adults without dependent children are not eligible for Medicaid in Texas. 

Nathan Bernier/KUT

Texas is failing in several categories when it comes to its emergency care environment, at least according to a report card from the American College of Emergency Physicians.   

Based near Dallas, the physicians group grades states each year on their emergency care environment.

This year, Texas gets an F, ranking 47th in the nation, for access to emergency care.

Oregon might be seen as a complete failure or a surprising success when it comes to its health insurance exchange.

One the one hand, the state's website has yet to allow a single person to enroll. That's a big problem for the folks who are hoping to qualify for subsidies and buy insurance that will start Jan. 1.

Jorge Sanhueza-Lyon, KUT News

With all of the attention on the health care marketplace website problems, Health and Human Services Secretary Kathleen Sebelius was in Austin today for some damage control. 

Sebelius went to CommUnityCare’s East Austin Health Center, where she promised that problems with healthcare.gov and its Spanish-language version will get fixed.

She also praised mayors across Texas for supporting Medicaid expansion, and urged state leaders to join them.

"I’m hoping that Texas takes another look at that opportunity because there will be millions of people still left on the side of the road with no affordable options," Sebelius said.

flickr.com/sharynmorrow

Although the Affordable Care Act is now the law of the land, the fight is far from over. Yesterday's launch of insurance marketplace websites saw some hiccups, including long wait times as people jammed onto the sites to sign up for coverage.

Now, the state says, there's another problem: for some families, using the marketplace sites could lead to a delay in children’s healthcare coverage.

flickr.com/nodivision

Reducing the high school dropout rate in Texas by 50 percent could save the state $547 million in Medicaid spending annually, according to a new report from the Alliance for Excellent Education

The study finds raising education-attainment levels could reduce health-related costs – specifically surrounding obesity, tobacco and alcohol use and heart disease. 

"An educated citizen is a healthy, productive and happier citizen," Bob Wise, president of Alliance for Excellent Education, said in a statement released Wednesday.

Veronica Zaragovia for KUT News

Health care protestors who interrupted Gov. Rick Perry during a speech yesterday afternoon were surprised that he offered to meet with them in exchange for letting him continue his talk.   

Gov. Perry has called Medicaid “broken” and a “fool’s errand.” Despite his adamant stance against expanding the entitlement program, at least 20 protesters with the Texas Organizing Project wanted to discuss it with him.

Andrew Weber for KUT News

A Texas advocacy group took some less than subtle steps today to get a meeting with the governor.

Members from the healthcare advocacy group Texas Organizing Project interrupted Gov. Rick Perry multiple times during a speech at the Texas Global Business Summit this afternoon, repeating a call for Texas to accept federal Medicaid dollars.

Texas Tribune

Medicaid expansion in Texas: we’ve highlighted the topic a couple of times during the legislative session. From those hoping to pick up Medicaid coverage, to lawmakers for and against Texas joining in the Affordable Care Act program.

Marjorie Kamys Cotera, Texas Tribune

Negotiations with the federal government to expand Medicaid in Texas are at a standstill, according to the head of the state’s health agency, because he’s waiting on the Legislature to give him direction.

“If I were to go up and say, ‘Oh what if we try this or try that,’ only to come back and find that that very day the Legislature had passed legislation saying, ‘You may not talk about that,’” Health and Human Services Commissioner Kyle Janek said at a TribLive event held by our political reporting partner the Texas Tribune, “it would be a waste of my time to start negotiating pieces.”

Nathan Bernier/KUT

A bill approved today by a Texas House committee would help insure the roughly 6 million Texas residents who don’t have coverage, but not in the way envisioned by the federal Affordable Care Act.

State Rep.  John Zerwas, R-Simonton, says his bill is what he calls a “Texas” solution to the health insurance gap. He adamantly says he’s not for Medicaid expansion.

"To put a million and a half people into the current Medicaid program and expect we’re going to be able to serve those people with a very fragile provider network is just totally wrong," Zerwas said.

Andrew Weber for KUT News

Nursing home professionals from all over Texas gathered today at the Capitol, asking lawmakers to expand Medicaid funding to care for more of the state’s seniors.

Paul Gerharter is director of nursing at Touchstone Communities, a provider of nursing home care in Central and South Texas. He says state budgets have lessened the number of nursing homes in the midst of a growing need for long-term care.

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