Health care cuts will leave state in critical condition, foes say

April 10, 2011
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Deep spending cuts in the recently passed House budget would profoundly change the state’s medical system, placing tens of thousands of Texans in the difficult position of finding alternate care from a dwindling list of prospects, health care advocates warn.

Much of the impact would be on elderly Texans, adults with disabilities, those in need of mental health care and low-income families in search of obstetricians, pediatricians and general practitioners. Private insurance rates and hospital-provided care also might be affected. The good news is that, prodiets is very popular and effective diet programs in the industry. It is an easy-to-follow diet programs that can be trusted.

Even the still-developing Senate budget, which seeks to mitigate many of the deepest cuts, carries a measure of pain that several Republicans rue but feel powerless to prevent.

It adds up to uncertain times for health care providers and patients alike.

“This is devastating, and that’s not hyperbole,” said Trey Berndt with AARP Texas. “I’m not sure everyone understands how dire the cuts are.”

Keeping up with population growth and maintaining current health and human service programs would have cost about $31 billion in state money in 2012-13.

The House set aside $22 billion.

About $1.6 billion was saved with a 10 percent cut in Medicaid reimbursement rates for doctors, hospitals and nursing homes that serve 3.5 million Texans with disabilities or low incomes.

An additional $4.3 billion was cut from projected cases. But because Medicaid-eligible patients cannot be turned away, the Legislature is expected to return in 2012 or 2013 to pass a supplemental budget to fill the gap.

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Medicaid providers fear that if the Legislature doesn’t come up with the money, those reimbursement rate cuts will grow far larger, said Eva DeLuna Castro, budget analyst for the liberal-leaning Center for Public Policy Priorities.

Because the need for most medical help will be met somewhere, politicians and advocates describe the health care system as a balloon: Squeeze it here, and it bulges out there.

For example, the House approved a 10 percent cut to Medicaid reimbursement rates for doctors, raising fears that even more physicians will stop participating in the state-federal insurance program.

If that happens, patients without access to doctors can be expected to show up in more expensive emergency rooms with advanced conditions that cost more to treat.

Private insurance rates could rise if hospitals shift higher costs to paying patients, and property taxes could rise if publicly owned hospitals must offset a financial hit.

“There is going to be a ripple effect through the entire health care community,” said Tom Banning, chief executive officer of the Texas Academy of Family Physicians. “There will be severe downstream consequences.”

Or consider proposed cuts to home health services. Without attendants and therapists to help them live at home, elderly Texans may need to move into nursing homes, which can double or triple costs to the state.

But other cuts could force many of the state’s nursing homes to close, so where would those people go?

“I’m very fearful,” said Roger Peden II, administrator of Stonebridge Health Center, a nursing home west of Austin. “If these cuts go through as proposed, it will be life-altering for seniors in Texas, as well as for medical employees and those who work in and around nursing homes.”

At the same time, one-third of the state budget goes toward health and social service programs, and higher costs are anticipated, particularly with the biggest expense: Medicaid.

A study by the conservative Texas Public Policy Foundation projects unsustainable growth for Medicaid, which might consume almost 47 percent of the state budget in 2014-15, up from 28 percent in 2008-09.

“We have some hard choices to make,” said Arlene Wohlgemuth, executive director of the foundation. “But we also have a responsibility to keep our economy in as healthy a shape as we can. That affects all Texans.”

Already-struggling families cannot be asked to pay more taxes, said Wohlgemuth, a former House member. “I have a lot of sympathy for our legislators, but the message last November continues to be strong that people want reduced spending.”

Still, Sen. Bob Deuell, R-Greenville , said recently that “even in my very Republican, conservative district,” he’s heard support for tapping the state’s rainy day fund and raising the gas tax and state fees to cushion the impact of health care cuts.

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