Medicaid Cuts

The Department of Health and Human Services is proposing a rule change that would cut Medicaid funding to public hospitals and other safety net providers. As Houston Public Radio's Laurie Johnson reports, if that rule goes into effect the Harris County hospital district stands to lose as much as $70 million in Medicaid funding.

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Health and Human Services could enact a rule change that would cut Medicaid payments to public hospitals by $3.8 billion over five years. The Harris County Hospital District estimates that would mean total losses of $224 million in Texas and $70 million here in Harris County. HCHD President David Lopez says the rule would place a cap on the payments the district could receive from Medicaid.

"By implementing this rule, we no longer have access to those funds that allow us to provide services to the uninsured and the underinsured in our community. So by default, it impacts us very negatively by restricting currently available dollars that will no longer be available to provide care to the people we serve in our community."

As it is, Medicaid funding covers about 60 percent of the district's costs. The rest comes from private insurance, grants, fees and state and federal matching dollars. So for every Medicaid dollar the district loses, they also lose federal matching funds. And it's those matching funds that make it possible for the district to provide services to the uninsured as well as specialty care and community health education.

"The new CMS rule shifts burdens for delivery of care and the financing of care onto the already over-burdened shoulders of public hospitals, local governments and ultimately local taxpayers."

There are about 1 million uninsured people in the Greater Houston area. U.S. Representative Gene Green says it's his opinion the rule change is misguided and unintentionally targets the poorest of the poor. The Centers for Medicare and Medicaid can implement the rule change without congressional approval, but Green says there isn't support for such a change among the Houston delegation.

"You know, whether it's in my area in East End or in North Houston or the West side there are people who need hospital district services. And so that's why I think we'll see a pretty good united front of members from the delegation, and not only our area but the state and the country, opposing this rule change."

The Centers for Medicare and Medicaid Services have proposed the rule change to go into effect in September of this year. Because it's a proposed rule, it's open for public comment and could be amended before finalization. CMS officials were unavailable for comment at the time of the filing of this report. Laurie Johnson, Houston Public Radio News.

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