AUSTIN — A push from conservative legislators for Texas to opt out of Medicaid is stirring alarm among healthcare providers and nursing homes, which say the potential loss of billions of federal dollars could drastically undercut efforts to provide healthcare for the poor.
The opt-out plan has quickly emerged as another high-profile topic for the 2011 Legislature, pushed by Gov. Rick Perry and a number of conservative lawmakers who believe that Texas can provide health coverage to the indigent more efficiently with a state-run plan free of federal mandates.
"We know how to deliver healthcare to more people in a less expensive way than what the federal government does," Perry said in Dallas last week while promoting his new book, Fed Up! He said states "need to stand up and say, 'We don't want your strings attached. We don't want you down here telling us how to run our business.'"
Perry's message reflects the anti-Washington mood that propelled him to a double-digit re-election victory this month and helped Republicans storm past Democrats to gain nearly two-thirds of the seats in the state House. Several leading conservatives in the Legislature are echoing Perry's idea.
"If we could opt out and design our own program, I've just got to believe we can do a lot more with a lot less," said state Rep. Phil King, R-Weatherford.
Healthcare advocates, however, are preparing to resist moves to pull out of the state-federal insurance program, which covers 3.1 million indigent beneficiaries, including 2.3 million children. The total cost of Medicaid for fiscal 2011 is $24.7 billion, with the federal government paying $16.6 billion, the Texas Health and Human Services Commission says.
"Unless our state leaders can come up with a financing plan to replace the current Medicaid structure that's even better than what we have now, I think it will ultimately end up backfiring and costing more in the long run," said Dr. Susan Bailey, a Fort Worth allergist and president of the Texas Medical Association.
Republican Rep. Mark Shelton, a Fort Worth pediatrician, said: "I think opting out of Medicaid without a viable alternative is not a good idea. We need to make sure . . . the vulnerable people in our society &mdash the poor, children and the elderly &mdash are taken care of."
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