HHSC's Proposed Medicaid Waiver: "Affordable" Coverage Should Not Come from Shrinking Benefits

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Anne Dunkelberg /(512) 320-0222 x 102

March 18, 2008

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As one step to decrease the number of uninsured, in 2007, the Texas Legislature directed the Texas Health and Human Services Commission to request a “waiver” of federal Medicaid laws to allow Texas to use federal Medicaid dollars to fund a health care coverage program that would be allowed to operate in ways not normally allowed under federal law. In developing a waiver, HHSC must balance keeping the cost per person low against the need to provide a decent and affordable standard of care. Top concerns for the low-income uninsured Texas adults who might be served are (1) a package with “bare-bones” benefits; (2) co-payments that are too high for the poorest parents; and (3) no clear policy on whether parents whose benefits run out will be in debt for the additional care they need. Achieving “affordable” care by cutting benefits dramatically (instead of finding a way to provide an acceptable standard of care) raises serious concerns. An overarching concern for all Texans is whether the financing of the proposed program will hurt our safety net hospitals, which are the backbone of the trauma system for every Texan—rich or poor. Finally, the amount of funding available for the new program is uncertain, and so the number of adults who will be able to enroll is also unknown. This policy page makes recommendations for improving the state’s waiver proposal and explains how you can voice your concern to state officials.