Neediest Texans could lose billions in Medicaid coverage under Trump budget, Obamacare overhaul – Dallas News

Texas spends roughly $40 billion on Medicaid annually, according to the Kaiser Family Foundation, making it the state’s most expensive health care program. Federal funds cover nearly 60 percent of the costs.

Under the AHCA, states like Texas would have the choice of receiving federal dollars through a block, or flat, per capita model. Studies indicate that will lead to a reduction in federal aid.

An analysis by consulting firm Avalere found that under the AHCA’s per capita funding model, Medicaid funding for non-disabled children would decrease by $43 billion over a decade.

Texas would see the largest decrease of all states under that model, Avalere estimates, losing $5.1 billion in funding between 2020 and 2026.

A March analysis of the AHCA by the left-leaning, Washington-based Urban Institute found Texas would lose $15 billion in federal Medicaid dollars over a 10-year period.

That leaves state officials facing even tougher choices about how to aid the state’s poorest, whether through reducing services, tightening already strict eligibility requirements or lowering provider reimbursements.

“All of those are very difficult decisions,” said Matthew Buettgens, a senior research analyst at the Urban Institute. “If you go with something like the Trump budget, Texas will have to start making decisions like that.”

What’s more, should millions drop off Medicaid rolls, hospitals should prepare for an uptick in uninsured visitors, warned health-care consultants with D.C.-based firm Advisory Board in a letter to clients last week. The CBO report, they said, is a “wake-up call for providers.”

Opting out

Dr. Deane Waldman, director of The Center for Health Care Policy with the conservative Texas Public Policy Foundation, said Texas has other options, even if the federally proposed reductions come to pass.

The state could pursue a new Medicaid 1115 waiver to opt out of costly federal regulations and receive funding through a fixed-sum block grant, he said, noting that the state is in the process of negotiating a waiver granted in 2011.

Waldman, a retired pediatric cardiologist and author of “The Cancer in the American Healthcare System,” estimates the cost of Medicaid compliance to be 40 percent of health-care spending in the U.S. 

If Texas was freed from those burdens, the state could use that money on patient care and reimburse doctors at higher rates so that they can accept new Medicaid patients, he said.


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