Texas Lawmakers Revisit Medicaid/Medicare Secession Scenario with Bill’s Intro

Consider this: With a rate approaching 30 percent, the state of Texas has the highest degree of uninsured in the country.

Consider this: With a rate approaching 30 percent, the state of Texas has the highest degree of uninsured in the country. Now consider this: It has always been known in healthcare policy circles that, if given the chance, conservative lawmakers in the state would choose to opt out of Medicaid because of what they see as a wild “unsustainability” in the federal-state program for the short term.

One of the state’s lawmakers, a Senate republican, is introducing a bill whose end result would create administrative partnerships (as presumptive methods to control healthcare costs) among health systems — a compact — that would allow the state opt-out as a feasible way of reining in the cost of healthcare delivery to the poor and uninsured in Texas. The price tag: almost half a billion dollars. While consolidating administrative redundancies to reduce costs, the bill would also have some undesirable provisions, according to healthcare advocates for Texas’s poor:

This law is more designed to set up the legal structures that will allow doctors and clinics and labs and hospitals and health plans to work together to restructure themselves in a way that they can share information and savings if they really not just keep costs down but actually improve people health outcomes. […] The bill allows Texas to ask the federal government for permission to take its share of funding and join other states in creating a compact, a healthcare program free of federal requirements.

It’s obvious that a federal opt-out is an impossiblity in the Obama administration, but it does open up the possibility for upping the ante in the reform debate via the anti-spending advocacy of the state’s current governor — who just happens to be considering seriously a run for the White House in 2012. | LINK