Medicaid Co-Pays: Proposals Moving Ahead

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Anne Dunkelberg /(512) 320-0222 x 102

May 10, 2011

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The 2011 Texas Legislature is considering a range of bills that would make major changes to Medicaid, from block granting the program along with Medicare and all other federal health funding, to using Medicaid as the laboratory for testing new models of care delivery and payments. Several bills, including the House and Senate budget bills, assume provisions to start charging some level of co-payments in Texas Medicaid. Given the current extreme revenue shortfall, the pressure to introduce co-payments is greater than ever before; for example, adoption of co-payments for visits to the emergency room that involve non-emergency medical care is considered likely. This Policy Page describes the Health and Human Services Commission’s (HHSC) proposals for Medicaid and the Children’s Health Insurance Program (CHIP) co-payments, the changes proposed in current bills, and the federal law and rules that Texas must comply with when imposing Medicaid and CHIP co-payments.