Hospitals in Texas explore more equitable distribution of Medicaid funds

Hospitals in Texas, hurting from the state's decision not to pursue additional Medicaid funds, are now exploring how to distribute current funds more equitably.

The Texas Hospital Association (THA) is exploring ways to overcome the program's current flaws, according to the Texas Tribune. "Texas hospitals have the power to work together to propose a solution and shape our own future," THA President Ted Shaw said in a statement, according to the article. "We recognize how contentious this issue is but understand the importance of a hospital-led solution to ensure that the losses are minimized and gains maximized."

Texas' GOP-dominated statehouse decided not to expand Medicaid eligibility under the Affordable Care Act. As a result, it forfeited some $100 billion over the next decade to insure approximately one million residents. And its acute care facilities are already dealing with cuts related to reductions in disproportionate share hospital (DSH) payments and the sequester. Meanwhile, lawmakers have been unable to craft a state-specific solution that would expand safety net coverage. The earliest the state can address Medicaid expansion again is 2015.

Texas is one of two dozen states that have declined to expand Medicaid eligibility, with the financial impact hammering hospitals that are already providing millions of dollars a year apiece in uncompensated care. Residents of those states who earn below 138 percent of the federal poverty level but more than the income cutoffs to qualify for Medicaid coverage also have few alternatives to obtain insurance coverage.

Although Shaw did not provide any specifics, THA officials told the Tribune that the goal is to distribute the existing Medicaid funds more equitably than the current system allows.

In the interim, Texas is wrestling with how to use a federal waiver grant to transform the state's Medicaid program. The grant could bring up to $11.4 billion to the state's hospitals over the next five years, and as much as $29 billion to the state overall, according to the Tribune.

To learn more:
- read the Texas Tribune article

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