Texas state capitol building in Austin
After several months of debate, potentially devastating cuts to Texas’s Medicaid reimbursement rates have been deleted from the state budget proposal, which was approved by a House-Senate committee on May 17.
The cuts — which had been supported primarily by the Republican-dominated Texas House — would have slashed Medicaid reimbursement rates for nursing homes by up to 10 percent. With the loss of matching federal funds factored in, the overall cut would have been closer to 33 percent.
Health care advocates had argued that as many as 80 percent of Texas’s nursing homes would have been forced to shut down as a result of the proposed cuts.
In a statement, the Texas Health Care Association said that, by maintaining the current Medicaid reimbursement rate, the latest budget proposal “will bring the Texas nursing home profession back from the brink of disaster and avert significant nursing home closures and job losses” if it is signed into law.
Concerns Remain
Health care advocates say they still have concerns about the latest version of the budget proposal, however.
Although the current Medicaid reimbursement rates are maintained in the next budget, advocates say they are still not high enough to genuinely influence the quality of care in Texas.
“We should never let ourselves become convinced that current reimbursement rates to nursing homes or home care providers are truly adequate to cover costs or entice direct-care workers to seek employment within this sector,” said Jane Bavineau, the executive director of Care for Elders, a Houston-based organization that focuses on eldercare issues.
“It is difficult now, and it will surely become more difficult in the years ahead,” Bavineau continued.
Indeed, the decision to maintain the current reimbursement rate for nursing homes will create an instant shortfall of $4.8 billion, which lawmakers will have to reckon with in 2013, the next time Texas has to submit a budget.
Community-Based Care Targeted
Additionally, the House-Senate committee agreed to cut $15 million from Community Based Alternatives (CBA), Texas’s Medicaid waiver program.
CBA coordinates the delivery of home care to Medicaid-eligible older adults and people living with disabilities who would otherwise have to live in a nursing home.
The cut represents approximately half of CBA’s budget.
The proposed $15 million cut “will harm home care agencies, which by definition harms consumers and direct-care workers,” said Dennis Borel, executive director of the Coalition of Texans with Disabilities.
“The tighter the belt, the harder it is for us to provide the care needed,” said Renee Tillman, a direct-care worker in Texas and the founding president of the Texas Association of Nurse Assistants.
Borel also said that he suspects that some home health agencies — particularly those in Texas’s sparsely populated rural areas — would not survive such a severe reduction in funding.
Health care advocates — including the Coalition of Texans with Disabilities — successfully fended off an attempt by the legislature to also cut CBA home care workers’ wages to the federal minimum of $7.25 an hour, from approximately $8.
– by Matthew Ozga
