The Texas Medical Association is applauding state leaders’ decision to leave Medicaid and CHIP benefits out of a planned 5% budget reduction for 2020-21. But TMA also is asking the state to protect physicians’ Medicaid payments and women’s health programs from its cuts.
A letter to the Texas Health and Human Services Commission (HHSC) from TMA and dozens of state specialty societies details the toll the COVID-19 pandemic has taken on physician practices. It notes that a directive from Gov. Greg Abbott, Lt. Gov. Dan Patrick, and House Speaker Greg Bonnen exempted Medicaid and CHIP benefits and eligibility, as well as behavioral health services, from the 5% cut. However, TMA’s letter says, it’s unclear whether the exemption applies to Healthy Texas Women; the Family Planning Program; CHIP-Perinatal; and the Early Childhood Intervention program.
The three state leaders directed all Texas agencies to cut 5% from their two-year budget for this year and next, which was originally established during the 2019 legislative session.
The letter requests that HHSC:
- Reject reductions in physician payments for Medicaid and CHIP; and
- Reject reductions in benefits and eligibility for women’s health services, including CHIP-Perinatal and Early Childhood Intervention, saying the programs “fit within the guidance that agencies preserve mission-critical services.”
The letter noted that measures taken to combat COVID-19, including social distancing standards and restrictions on elective medical procedures, have taken a toll on physician practices. Most practices “keep only one or two months of cash on hand, if that,” the letter said, and physicians who primarily see Medicaid patients haven’t yet seen anticipated funds from the federal Coronavirus, Aid, Relief, and Economic Security (CARES) Act.
“As a result of these collective blows, physician practices have laid off staff, reduced salaries and benefits, and even closed, some permanently,” the letter said. It pointed to results from TMA’s May 2020 Practice Viability Survey, in which 63% of respondents reported a drop in revenue of 50% or more as a result of the pandemic, and 62% reported cuts in physician salaries.
“Reopening the state’s economy will undoubtedly help, but the pace is slow and uneven,” the letter said. “Medicaid-participating physicians simply cannot absorb any more payment cuts.” And community-based physicians can’t recover Medicaid losses, the letter notes – unlike hospitals, which have avenues for doing so.
The letter also notes that historically, when Texas has slashed Medicaid physician payments by as little as 2%, the number of physicians who report accepting all new Medicaid patients falls significantly.
“The economic wounds suffered by the state are grievous, and precise cuts are required before they can heal,” the letter said. “But performing this life-saving procedure requires a scalpel instead of a cleaver. Deep cuts in the wrong places risk harming not only the health and well-being of the people we serve but also the pace of Texas’ economic recovery.”
TMA also urged HHSC to avoid the same cuts, and protect Medicaid and CHIP benefits and eligibility, in its eventual budget request for 2022-23.