Wednesday, March 23, 2011

Great Texas ExPerryment: No Debate, Discussion or Amendments

The House Appropriations Committee approved a bone crushing budget that decimates public education and health/human services over the next two years.  The plan passed on party lines with no discussion or debate.  Representative Drew Darby sits on the Appropriations Committee.  Darby's staff weighed in via e-mail:

Appropriations Committee members have until Monday to file amendments to HB1. Trent Thomas, chief of staff for San Angelo's state Rep. Drew Darby, who serves on the committee and chairs one of its subcommittees, said in an e-mail that Darby doesn't plan to file any amendments "at this time."
The last time I saw Rep. Darby he remarked the budget had "nearly all his constituents mad at him."  His defense, "No one wants to pay more taxes,"  was challenged by an ASU professor.  Her "I will" negated Darby's assertion.

The Standard Times reported:

The House plan reduces reimbursement rates to nursing homes and other Medicaid providers, a change that could jeopardize 45,000 residents in the state's 550 nursing homes that depend on Medicaid, experts said.
The Medicaid reimbursement rate cut is only a quarter of the hit providers will take.  Over half of the funding loss is due to the federal government no longer picking up a greater share.  Under stimulus spending the federal share rose from 60% to 78%, but it's reverting back to the 60% level.  Texas legislators complain about this "cost shift."

Nursing home advocates say the true cut to nursing homes is closer to 33 percent because of recent changes in the federal-state funding formula.
Many nursing homes stated they will need to cut services, even close.  Area hospitals will need to cut staff and services, while continuing to shift Medicaid related costs to other payors.

Other groups walking away from health care coverage include the City of San Angelo, which dropped nearly 200 insureds January 1.  SAISD will eliminate 75 positions over a two year period, jobs that formerly provided health care coverage.  The school system plans to pass a greater share of the premium to employees, like the City recently did.  How many SAISD employees and dependents will lose coverage?

With nursing homes closed and up for sale, area hospitals will have difficulty transferring patients.  Sick patients could stack up in hospitals, with fewer sub-acute care resources in the area.

Hospitals will lose more money per Medicaid patient, the "cost shift" Texas legislators avoid discussing.  Physician practices could restrict access for Medicaid patients, leaving Esperanza Clinic and area emergency rooms as their avenue for treatment.  Esperanza is yet to share the impact of Medicaid cuts, but Shannon and Community could together lose over $25 million in funding.

With crisis comes opportunity.  Nursing home closures could provide The Carlyle Group, a frequent benefactor of Governor Perry's largess, an opportunity to purchase nursing homes at fire sale prices.  While it might not be part of a plan, it could benefit the super rich, who have the chops to ensure "no new taxes."

We'll know how the "Great Texas ExPerryment" worked in three years.  My prediction is lots of pain, physical and economic.  How will the silent "yes voting" legislators pay for their draconian cuts to health care and education?  That remains to be seen.

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