Tragedies in Medicaid Managed Care as Texas Squeezes Funding & State Revenue

The 16-month-old boy in foster care who was left in a vegetative state after he didn't get the care that medical professionals recommended.

The woman with disabilities who contemplated suicide after she didn't get care that medical professionals recommended.

These are just two of the tragic cases documented in the powerful investigative series the Dallas Morning-News published last week on the state's Medicaid managed care system.

The stories in the series, and the concerns that were previously reported to state leaders, raise a number of issues. They demonstrate how important Medicaid is for so many Texans. They show how important it is for state leaders to ensure that Texans get the care they need. And they point to a number of policy areas for state leaders to address, such as provider networks, reimbursement rates, oversight of managed care organizations, and more.

We expect a lot of discussion about those issues at the June 20th and June 27th legislative hearings on Medicaid managed care.

But on a more fundamental level, the problems highlighted in the state's Medicaid managed care system highlight the real human costs of state leaders repeatedly focusing on cutting off sources of state revenue for the state budget and then insisting on squeezing more "savings" out of underfunded health care programs for Texans.

As the Coalition of Texans with Disabilities pointed out in this column, this is largely the responsibility of the state Legislature.

In recent years, the Legislature has taken billions of dollars off the table for health care and other priorities by pushing through additional tax cuts for large businesses and other measures.

Faced with less revenue to cover the state's priorities, lawmakers then turn around and insist on finding new ways to limit funding for people with disabilities, seniors, children, and pregnant women enrolled in Medicaid. They've reduced reimbursement rates for life-changing therapies for kids with disabilities. They've underfunded Medicaid with the expectation that the next Legislature will cover the bills. And they've passed "cost containment" budget provisions that insist on reducing funding for Medicaid managed care, assuming someone will figure out how to save the money if the state budget simply declares that it must happen.

Now we've seen that someone will figure out how to save the money if you simply insist that it happens. And we've seen the devastating consequences of making those cuts and limiting state revenue without considering the health care needs of Texans.

We call on state leaders to address the particular problems that have been identified in Medicaid managed care but also to keep in mind the people highlighted in this Dallas Morning-News investigation next time they consider policies that squeeze the funding required to meet the state's health care needs.