Texas Republicans talk tough about dropping Medicaid; other states consider steep cuts

As the Medicaid program continues to consume more of states' budgets each year, Republican lawmakers and the just-reelected GOP governor, Rick Perry have an idea: Opting-out of the program altogether, the Houston Chronicle reports. "The prospect, described by some as far-fetched, raises fears about the toll on poor children, people with disabilities, pregnant women and the elderly. Medicaid covers at least part of the cost for more than 60 percent of nursing home residents." Proponents of the opt-out plan, like Rep. Warren Chisum, a candidate for speaker of the Texas House, are hoisting the idea as a a way to save money; Texas legislators are contending with a $21 billion, two-year deficit and Republican candidates pledged on the stump not to raise taxes (Fikac, 11/14).

The Fort Worth Star-Telegram: Opting out of Medicaid is just the type of state-federal stand-off that surfaces on stops for Perry's book tour for the recent volume "Fed Up!" At a tour stop in Dallas last week he said, "We know how to deliver healthcare to more people in a less expensive way than what the federal government does. … We don't want your strings attached. We don't want you down here telling us how to run our business" (Montgomery, 11/13).

The Austin American-Statesman: That's not how the health sector sees it. "Never mind that no state has ever ditched Medicaid. Or that the federal government typically kicks in about 6 of every 10 dollars spent on the health care program in Texas. Medicaid pays for more than half of all births and chips in for the care of nearly two-thirds of all nursing home residents in the state. And top medical industry officials say opting out of Medicaid would cripple the state's health care system and hurt the economy." The opt-out plan was pioneered by the Heritage Foundation, a conservative Washington think-tank before the health law was passed (MacLaggan, 11/13).

Earlier, related KHN coverage: States' Woes Spur Medicaid Drop-Out Talk (Ramshaw and Serafini, 11/12).

Meanwhile, in other Medicaid news:

Houma (La.) Courier: "A group that represents ambulance companies, hospitals and doctors is taking a stance against the Medicaid budget cuts being proposed by Gov. Bobby Jindal. It is the opening salvo in what is expected to be a heated debate in the coming weeks as state health officials firm up plans in time for a Dec. 1 effective date" (Alford, 11/14).

The Columbus (Ohio) Dispatch: "The state budget crisis has put a target on the backs of 2 million Ohioans on Medicaid -- children and pregnant women, the disabled and elderly -- but scaling back the tax-funded health-care program comes with its own price tag. For every dollar Ohio cuts in Medicaid spending, it loses $2 in federal matching funds" (Candisky, 11/14).

The Lansing State Journal: "In a 16-county swath across Northern Michigan, pregnant women have to drive an hour or more to reach a hospital where they can deliver their babies. From Cheboygan to West Branch to Clare, hospitals have been closing their obstetrics units since last summer in a startling domino effect that has health care activists worried about care availability for rural mothers and babies. But they're equally alarmed about the reason behind the hospital closures. The hospitals blame, in large part, Medicaid." Since 2002, the state has been reducing the amount it reimburses doctors and hospitals for taking care of Medicaid patients. Some providers say it has reached a "a painful bottom-line reality: It has become too expensive to treat poor people" (Ahern, 11/14).