Texas doctors are opting out of medicaid. Essentially the government wants to expand the medicaid rolls while reducing the payment fees. That is a disastrous business model for any “free enterprise system” and is a harbinger for what will be down the road for us unless we get a Republican congress committed to defunding the beast.
by Robert T. Garrett
Doctors in the Dallas area and across Texas are threatening to opt out of Medicaid because of payment cuts, which would further damage the state’s already uneven delivery of health care to the poor.
The 1 percent trim to provider fees that starts Sept. 1 sounds modest. But doctors, insurance industry officials and health care experts widely see it as the first of many hits coming to doctors’ wallets as Texas’ fiscal woes deepen.
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. 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 cut demonstrates a potentially recurring problem with budget cuts as state leaders contemplate a shortfall that could hit $18 billion: Cuts that lawmakers make now to programs that are already stretched thin could cause deeper long-term woes.
Obstetrician Lou Montanaro of Carrollton said he wants to stay in the Medicaid program, barring draconian cuts. Still, despite a quarter-century of seeing Medicaid patients, Montanaro says Texas’ low reimbursements have forced him to limit the type of Medicaid patients he takes: Pregnant women, yes; other women seeking gynecological care, no.
Because eligibility rules are tight, most Texas women don’t qualify for Medicaid coverage unless they’re pregnant or disabled, Montanaro said, and disabled women’s complex medical conditions overwhelm his solo practice.
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Banning said doctors trying to stay in business “have tended to look at what is the lowest-paying part of the market, which is Medicaid. It’s not a hard economic decision.”
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Tags: Obamacare
