TMA's Medicaid Recommendations Can Improve Care, Reduce Costs

As state lawmakers begin preparing for the 2017 legislative session, TMA and four state specialty societies delivered a detailed, five-page document with significant recommendations to improve the Texas Medicaid program. Among the suggestions submitted to the Senate Health and Human Services Committee:   

  • Enact creative solutions to increase health care coverage among low-income Texans;
  • Cut Medicaid managed care red tape, and pay physicians competitive Medicaid and Children's Health Insurance Program rates;
  • Promote better birth outcomes by enhancing women's access to preventive, primary, and behavioral health care;
  • Increase access to evidence-based community and crisis mental health and substance abuse services; and
  • Improve state efforts to provide women's preventive and primary care. 

The organizations' recommendations cite Texas' uninsured rate, with more than 5 million Texans lacking health insurance. "Among adults, the majority of the uninsured work, but either they cannot afford employer-sponsored insurance, or it isn't available. Purchasing private health insurance is prohibitively expensive for low-income families. But insuring more low-income Texans does not have to mean expanding traditional Medicaid. A half-dozen conservative states —  including Indiana and Michigan — have implemented innovative programs to privately insure more people mostly paid for with federal dollars," the testimony states. 

Rather than expanding traditional Medicaid, TMA, the Texas Pediatric Society, the Texas Academy of Family Physicians, the Texas Association of Obstetricians and Gynecologists, and the American Congress of Obstetricians and Gynecologists-District XI urge lawmakers to "develop a plan, tailored to Texas' unique circumstances, to cover more than 1 million uninsured individuals." They explain the plan would "provide low-wage, working Texans with private insurance that includes copays and personal responsibility."

The organizations' testimony also supports efforts to extend the 1115 Medicaid Transformation Waiver. "Even with broader health care coverage, the safety net system's ability to care for vulnerable Texans will be seriously imperiled if hospitals lose supplemental federal funding for uncompensated care. Moreover, the Delivery System Reform Incentive Payments funding designed to test new ways to deliver and pay for care is starting to show genuine improvements in health outcomes. The waiver renewal must ensure greater community-based physician involvement in waiver planning and evaluation," they wrote. 

Action, Oct. 3, 2016 

Last Updated On

January 10, 2017