Medicaid cut threatens care in Texas

Doctors in Texas are threatening to drop Medicaid patients if a scheduled reimbursement cut takes hold later this summer, the Dallas Morning News reported Sunday. 

To help shore up their budget in a tough economy, Texas lawmakers have scheduled a 1 percent cut in Medicaid provider rates, which takes hold Sept. 1. 

But Medicaid rates in Texas are already so low that most doctors already limit the number of Medicaid patients they’ll see — or refuse them outright. The new, looming cut would mean that even more doctors would likely stop seeing those patients, leaving some of the most vulnerable in the state without access to care. And the 1 percent cut could just be the start.

“State leaders’ instructions for agencies to identify additional 10 percent budget cuts in the next two-year budget cycle mean more fee cuts may come next summer,” the Morning News reported. “Experts say further reductions could drive off doctors, dump more patients on hospital emergency rooms and ensure a rocky start for the federal health care overhaul, which by conservative estimates could add 1.5 million Texans to Medicaid by 2015.”

The issue has national implications. Although not every state is eying Medicaid cuts, low provider reimbursements have limited doctors’ participation in the program country-wide. The problem is especially pressing because the Democrats’ new health reform law expands Medicaid considerably. Indeed, roughly half of the 30 million uninsured Americans estimated to get new coverage under the law will be enrolling in Medicaid.

To address the reimbursement issue, the law includes a provision hiking Medicaid rates to equal Medicare rates for primary care services. But the hike is temporary, meaning that lawmakers will likely have to return to the issue in 2014 if they hope to ensure that Medicaid coverage translates into care for those patients.