State lawmakers consider Medicaid changes

The Houston Chronicle: "Some Republicans who talk about Texas potentially opting out of Medicaid are quick to say the changes wouldn't throw people out on the street — but not House Appropriations Committee Chairman Jim Pitts." Pitts didn't advocate the Medicaid change but "gave a stark answer when an audience member asked about an ill friend who is on Medicaid." The questioner asked what would become of this ill friend and would that friend be thrown out into the street. "'If we did exactly what we're doing today, we wouldn't be throwing him out in the street. But if we have any savings in getting out of Medicaid, we will have to throw some people out in the street,' said Pitts, R-Waxahachie. He noted, 'I'm not telling you that your friend would be.' … The Texas Health and Human Services Commission is looking at the Medicaid issue and plans to report to lawmakers soon" (Fikac, 11/29).

Texas Tribune: "Pitts told the crowd that the state is studying Medicaid and other forms of government-run health care with the idea of getting out of it." In addition, "[t]he initial budget [Pitts] and his fellow budget writers will present a few weeks from now will eliminate some state agencies, make large cuts to others ... and might include furloughs of state employees." Texas lawmakers are facing a challenge in that "[l]ess than half of the $182.2 billion biennial state budget is unrestricted, with education and health and human service programs accounting for most of that discretionary spending. …You simply can't get to the bottom line without cutting inside those programs" (Ramsey, 11/29).

The (Lakeland, Fla.) Ledger, in its Capitol Comment column: In Florida, Medicaid "now accounts for about $20 billion out of the state's $70 billion annual budget. It is projected to claim more than a third of the budget by 2015." As enrollment is expected to grow as health law takes full effect in 2014, "[s]upporters of the health care law say Florida is a good example where Medicaid expansion is needed because one out of five Floridians has no health insurance. But critics, who include most of the legislative leadership, see the federal law as a costly mandate that they will resist" (Dunkelberger, 11/28).

Illinois Statehouse News:  "Illinois Senate leaders have charged a few select lawmakers with reforming the state's Medicaid program and workers' compensation system — by Jan. 3. But members of the bi-partisan commissions aren't scared off by the tall order due in a little over six weeks." State senator Dale Righter, co-chair of the Medicaid commission, "said the 2014 expansion just adds to the urgency for reform. … State officials have said new participants are expected to cost the state about $200 million annually. Although the federal government will initially pick up 100 percent of the costs of the new enrollees, its contribution will ratchet down to 90 percent after 2019. Righter said implementing managed care in the Medicaid program — where a patient is assigned to a single doctor who acts as a gatekeeper for all health care, much like an HMO — must be on the table" (Massingale, 11/29).

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This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.