Hospitals that serve large uninsured populations in Texas stand to lose critical funding if the state can’t convince the federal government to continue helping with the cost, doctors and health advocates told the state health department Thursday.
With the expiration date of a five-year, $29 billion program approaching, the Health and Human Services Commission will attempt to negotiate a renewal of federal funds to help reimburse hospitals caring for the uninsured.
Rural Texas hospitals serve large uninsured populations and rely on the money to keep from closing, Grace Chimene, a pediatric nurse practitioner, told a panel of HHSC administrators taking public testimony on the need for an extension.
“When a rural hospital closes, lives are lost due to the lack of emergency services,” the Austin resident said. “If you have an emergency like a heart attack in rural Texas, you better hope that local community has enough insured population to support a community hospital.”
The money was originally intended to help Texas transition over five years to an expanded Medicaid program under the Affordable Care Act. But Texas officials decided not to expand Medicaid, the state-federal insurance program for the poor and disabled, leaving uninsured nearly one million residents who would have been eligible for coverage under the expanded program.
That was a rebuke of the Obama administration, which is now considering whether — or to what extent — it will renew the matching funds. Federal officials told HHSC in April they would consider Texas’ refusal to expand Medicaid when determining whether to renew the federal matching funds that supplement local dollars.
The month-long public comment period for HHSC’s proposal to have the funding extended another five years will end August 5. The deadline to reach a deal with the federal government is September 30.
However, many who testified said Medicaid coverage expansion itself is more important than extending the five-year program, and urged the HHSC to pressure the government to expand coverage.
“Coverage expansion must be part of the solution,” said Laura Guerra-Cardus, an Austin doctor who serves as associate director of the Children’s Defense Fund in Texas. “Without coverage, individuals do not have adequate access to preventative, chronic and ongoing care that makes the concept of health care meaningful.”
HHSC must submit its request for extending the waiver by the end of September. If it fails, the money would run out in September 2016.
See here and here for the background. I’ll say again, I hope the feds stand firm and make it clear to Texas that this money is contingent on Medicaid expansion, no ifs ands or buts about it. Ideology is the only reason for the opposition to expanding Medicaid. Let’s make it perfectly clear to the hospitals and the communities they serve that stand to get screwed by this who and why it is happening. As they say, elections have consequences.