Health Lobbyists Prepare For More Battles In Austin In January

Medicaid looms largest for hospitals and doctors who care for the uninsured.


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[flickr/Phil Roeder]

Medicaid looms largest for hospitals and doctors who care for the uninsured.

The future of Medicaid, the government health insurance program for the poor, could dominate in the upcoming 84th legislative session. Many health advocates, clinics and hospitals were disappointed that Texas did not expand Medicaid in the session that concluded this past summer.

By doing so, the state turned away millions of dollars in federal funds, that could have gone to the medical safety-net that cares for the uninsured.

But the decision was not surprising, because the Medicaid offer was part of the Affordable Care Act. Texas Republican leaders have continually fought against anything having to do with the ACA, also known as “Obamacare.”

Tim Schauer handles government relations for many Houston clients in the healthcare industry.

He said the politics surrounding the Affordable Care Act have caused difficulties for his clients, especially those who care for the uninsured. 

“They’re trying to budget, they’re trying to look forward,” Schauer said. “Whether you (are) in a small doctor’s office, a clinic or a hospital, you want some level of certainty in making decisions.”

Until a new governor is elected in November, it’s difficult to predict what will happen.

But even if power remains in Republican hands, there might be room for a so-called “Texas solution” to the Medicaid fight — a compromise plan to cover more uninsured Texans through Medicaid, but with more flexibility than allowed by Obamacare.

Freddy Warner represents the Memorial Hermann Healthcare System in the state capitol.

He pointed out that a few other red states, like Arkansas and Ohio, have managed to expand Medicaid despite Republican opposition.

Warner said some Republicans in Texas are watching how things unfold in those other states.

“They’re paying attention, they’re reading about what happened in Arkansas, what’s going on in Ohio,” Warner said. “I think that’s very encouraging for us.”

If Texas did decide to expand Medicaid, it could receive $18 million dollars a day in federal healthcare funds.

“It’s an economic issue obviously,” Warner said of the lawmakers. “After they’re hearing from a lot of the hospitals and the providers, they are starting to see a lot of money that was left on the table.”

Although the next session is nine months away, the healthcare industry is already putting together its agenda and meeting with lawmakers and staff members.

Other issues for lobbyists in the upcoming 84th legislative session include the levels of Medicaid reimbursement for doctors, which have been subject to cost controls in past legislative sessions.

And the Texas Commission on Health and Human Services is preparing to undergo a so-called “sunset review” in which its operations will undergo a thorough review.

Healthcare lobbyists say a sunset review can be a good opportunity for health organizations and everyday Texans to air their grievances and for the state to implement changes, such as streamlining operations and overhauling funding for health programs.

“You have literally four different women’s health programs,” said Schauer, as an example. “You have several different disease-oriented programs, everything from the Ryan White [HIV] program to diabetes to heart disease.”

“And at some point — and sunset (review) is a perfect opportunity —  you ask ‘Why do we have all these separate different programs?’” Schauer continued. “Couldn’t we roll them into a comprehensive coverage program?”

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