By: David Huffstutler
Texas has a significant number of uninsured and underinsured residents. Almost a quarter of the residents in our state—more than 6 million people—are uninsured. This means one of every four people in Texas do not have health insurance. Add these individuals to the estimated 4 million underinsured Texans receiving basic healthcare through the Texas Medicaid program (75% of whom are pregnant women and children), and we have a total of 10 million uninsured and underinsured Texans—that number is greater than the entire populations of Arkansas, Louisiana and New Mexico combined (according the U.S. Census Bureau). Although Texas is making progress on reducing its number of uninsured, the challenges of caring for the uninsured and underinsured, as well as hospitals’ uncompensated care burden, remain.
In Texas, the Medicaid 1115 Waiver fortifies the “safety net” that makes it financially possible for hospitals to care for our vulnerable populations.
Approved in December 2011, the Waiver is transforming how healthcare is delivered and paid for in this state. It is critically important in Texas—where we have an aging and growing population, and importantly, where elected officials will not expand Medicaid.
The Waiver has two primary purposes:
- It transforms fee-for-service Medicaid into a managed care system for most of the state.
- It creates two pools of funding for uncompensated care—the first for reimbursing hospitals for the cost of care for Medicaid and uninsured patients (for which the hospital does not receive payment) and the second to provide incentive payments to hospitals and other providers that improve the quality and lower the cost of care.
Unfortunately, the Waiver is scheduled to expire on September 30, 2016.
St. David’s HealthCare, along with hospitals across Texas, is working with state and federal officials to get the Waiver renewed.
The Medicaid 1115 Waiver is critical to sustaining access to high quality healthcare for the vulnerable in Texas. If it expires in September 2016, the impact will be devastating for patients and hospitals in our state, where uncompensated care costs are projected to reach almost $8.8 billion in 2019*.
Expiration of the Waiver will have a wide-ranging impact. Taxpayers, insured Texans and employers who offer health benefits will pay more to cover care for the uninsured and underinsured.
The State submitted its Waiver extension application earlier this month.
Join hospitals across Texas by contacting your congressional member to let them know you support renewal of the Medicaid 1115 Waiver.
*Texas Hospital Association, 2015
Infographic courtesy of Texas Hospital Association.