Medical Journal - Houston Page 4 April 2013
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The path to Medicaid expansion , reform possible
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Discussion on Texas solution meaningful opportunity for Texas
Special to Medical Journal – Houston By Dan Stultz , M . D ., FACP , FACHE , President / CEO , Texas Hospital Association
Texas legislators this month began turning up the volume on the issue of Medicaid expansion , which could flow more than $ 65.6 billion in federal funds to Texas over the next 10 years while requiring about $ 18.6 billion from the state .
Texas hospitals appreciate state leaders for their willingness to consider innovative , flexible solutions to serving the Medicaid population . As proposed in other states , a variety of options exist for Texas to create its own unique Texas Medicaid solution . We also believe the federal Affordable Care Act provides a more expeditious pathway to reform short of waiting on the federal government to approve a state block grant of the entire program .
The need is significant .
Currently , a quarter of our state ’ s residents are uninsured , putting pressure on employers and their employees to cover uncompensated care costs through higher health insurance premiums . Expanding coverage reduces pressure on Texas business owners in a variety of other ways as well . The most important is its ability to decrease $ 448 million in penalties from “ shared responsibility ” payments employers will face for not offering health insurance benefits to employees . We also know that employees with health coverage have better access to primary and preventive services , which improves health and reduces medical expenses . Covered employees also have improved health outcomes , which leads to lower absenteeism and increased productivity .
Taking this step to reform Medicaid would get more Texans the preventive care they need before an emergency arises while helping to relieve the stress on emergency rooms that often are faced with patients in need of routine care . In addition , it would help get workers back on their feet faster as their access to quality care improves .
Although Texas hospitals recognize concerns with the current Medicaid program , Texas is a national leader for its work with the state to move most of the acute care program into a private-market managed care model . This ensures access to primary care services and better care management . Additionally , the Medicaid 1115 Transformation Waiver provides incentives for hospitals to invest in primary care and mental health capacity in their communities that will improve access to quality care and divert costly inappropriate emergency room utilization .
Medicaid expansion equals coverage expansion , and the funding will --- no doubt --- help Texas hospitals . In the broader view , though , Medicaid expansion is the right thing to do for Texas , and a growing chorus of Texans is speaking up . A recent survey of Texas voters shows a strong majority of Texans in favor Medicaid expansion .
Additionally , the current opportunity to work with the federal government to create a Texas solution using Medicaid expansion funding will create greater access to health care for working Texans , many of whom are gainfully employed but cannot afford health care coverage in the private market .
We believe there is a path to Medicaid expansion .
It ’ s a path to shared responsibility . ... to put a Texas solution in place that works with federal programs .
... to place safeguards that ensure the federal government maintains its commitments .
... and to include patient accountability .
Texas hospitals urge Gov . Perry and other Texas leaders to allow this dialogue , to seriously research what could be allowed by CMS to expand coverage in Texas . It ’ s the right way to ensure coverage to reduce uncompensated care ... but at the end of the day , it ’ s the right thing for everyone .. t