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Who can get health care in Williamson County

This is a bad idea.

Williamson County commissioners have decided to stop paying health care costs for indigent adults and children who don’t have valid Social Security cards.

County Judge Dan A. Gattis said last week that he wanted to ensure that there was enough money for the residents of Williamson County who qualified for indigent care to remain covered. In the first five months of the current fiscal year, 265 people who didn’t have Social Security cards received county-paid health care out of a total of 1,153 indigent patients , said Bride Roberts , the coordinator for Williamson County’s indigent health care system.


Roberts said there were several reasons for the increased expense, including a large number of “very sick” people and new hospitals in the area identifying more people who may qualify for the program.

Williamson County residents without legal Social Security cards can still get care at four clinics in Georgetown, 10 clinics in Round Rock and one in Granger, all operated by Lone Star Circle of Care, a nonprofit community health organization, said Rebekah Haynes, the group’s communications director.

Roberts said patients without valid Social Security cards accounted for 12 percent of the $3.7 million spent under the program in the first five months of the fiscal year. During fiscal year 2009, 1,505 people were covered, and 331 of those didn’t have valid Social Security cards , she said.

The county estimated that it can save $1 million a year by denying coverage to people without legal Social Security cards, Roberts said.

Medicaid doesn’t cover health care costs for adults and children without legal Social Security cards. Texas law doesn’t address whether counties can exclude people without legal Social Security cards, said Anne Dunkelberg, the associate director of the Center for Public Policy Priorities in Austin.

“Virtually all counties do include undocumented residents in their county indigent health care programs,” said Dunkelberg, who called the county’s decision “a bad idea.”

“Making sure you are providing good access to prenatal care is extremely important because all babies are U.S. citizens,” she said.

My first reaction when I read this was “Do they really make people produce their Social Security card when they show up needing a doctor?” I mean, I sure don’t carry my SocSec card around with me. Having it on my person makes me more vulnerable to identity theft, and while I’m occasionally asked for my SSN, outside of a periodic I9 check at work, I can’t remember anyone ever asking me to produce my card. Is this really the procedure, or was this another way of saying “people with valid SSNs”?

My second reaction, as is usually the case when some public official expresses in words or actions indifference to the health and well-being of some subset of the population for which he or she is responsible, is to wonder if they’ve ever read The Masque of the Red Death. At least there’s still someplace in Williamson County for the less equal than others to go, which makes WilCo a notch above Collin County, but it’s still the case that making it harder for people who need health care to get it ensures that more people will be needlessly sick, and some of them will die. Some of these people, as the story notes, will be children. Maybe I’m just not cut out to be a County Commissioner, but I sure wouldn’t want that on my conscience.

I realize that WilCo is facing budget issues, and that they don’t have infinite resources. Rising health care costs is a big problem, one that the Affordable Care Act will eventually make some headway on, but which they need to cope with now. I just think they made a poor policy decision, one that offers a false savings in the same way that cutting back on CHIP did in 2003. I hope they figure it out before it hurts too many people. EoW has more.

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