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Sunday, June 6, 2010

Does Straus think Texas should end Medicaid?

4:59 PM Thu, Jun 03, 2010
by Robert T. Garrett/Reporter

Speaker Joe Straus added a line this week to his close-the-budget-gap-without-taxes pep talk: Take a look-see at all those federally financed programs that Texas administers. Someone. Please.

OK, the actual words Straus used in an op-ed piece in the Austin American-Statesman on Tuesday were a tad less blunt but certainly intriguing. After urging colleagues to consider a partial freeze on state hiring and salaries, he said:

"Other ideas that should be analyzed include re-evaluating the state's responsibility for administering various programs, including federally-sponsored programs ..."

Does he mean Medicaid, which Republican leaders have complained for years is devouring the state budget? Even though the Texas Medicaid program, at least until this bleak recession, had a rate of spending growth that was below the rate of medical inflation generally? And notwithstanding that it's a major financial prop under the state health care industry?

"It wasn't necessarily intended to be a signal of a specific way to go, or anything other than just looking at all the options," Straus spokeswoman Tracy Young said today. "It's just a continuation of what he asked the Appropriations Committee to do," she said, referring to Straus' unusual appearance before the House's budget writing panel last month.

If you look at the remarks he made then, you won't see mention of, hey, maybe Texas should pull out of some federal programs. Then again, Straus dropped from his op-ed his earlier call for perhaps improving state collection of unpaid fines and fees. So perhaps we parseth the speaker's utterances too much. On the other hand ...

Conservatives such as former Rep. Arlene Wohlgemuth, R-Burleson, now at the Texas Public Policy Foundation, have bitterly complained of strings attached to the huge federal dollars flowing under Medicaid but have stopped well short of urging that Texas dismantle its program.

Some 64 percent of Texas Medicaid's current, two year budget of $45 billion comes from the feds. It's the state's single biggest source of federal moolah.

And liberals such as former state District Judge F. Scott McCown, of the Center for Public Policy Priorities, stress that Medicaid doesn't just pay for the delivery of half of Texas' babies each year, it covers the nursing home tab for a huge percentage of people getting those services -- including former members of the middle class, who've "spent down" their assets and qualify for government-paid care.

"These programs are essential and widely popular," McCown said. "People don't connect all the dots but if you took all the programs away, they'd connect the dots pretty fast."

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