TPPF, State Leaders: Medicaid Growth Is "Unsustainable"

The Texas Public Policy Foundation, a conservative think tank, joined with Lt. Gov. David Dewhurst and House Public Health Chair Lois Kolkhorst this morning to offer solutions to the state's Medicaid cost crunch. They suggested Medicaid, which currently makes up 28 percent of the state budget, will grow to nearly half of the state budget in the 2014-15 biennium, a spike they said is completely unsustainable. 

"Even without Obamacare, the cost of Medicaid will double every decade," said TPPF Executive Director Arlene Wohlgemuth. "Reform is not only necessary, but it is quite feasible." 

TPPF's potential solutions?

— Replacing Medicaid with a state-driven TexHealth program, which would put Medicaid patients into the private market and subsidize the cost of the insurance premium on a sliding scale. 

— Getting Congress to approve an interstate compact — essentially a block grant that would give Texas a lump sum from the federal government to operate Medicaid. 

— Dropping Texas' Medicaid population into a "health insurance exchange," under the assumption that, without a Texas Medicaid program, federal health reform requires Washington to subsidize health care for impoverished Texans.

— Requesting a so-called "1115 waiver," which would allow Texas to try out policy innovations for five years, so long as the reforms don't cost the federal government anything more. 

Dewhurst has worked with Sen. Jane Nelson, R-Grapevine, to file Senate Bills 7 and 8, both of which touch on payment reform and ways to curb skyrocketing health care costs. Those measures are "completely unlike Obamacare," Dewhurst said — a reference to suggestions that the state and federal legislation bear some similarities.

Kolkhorst, R-Brenham, said she's preparing to file legislation more specific to solving the state's Medicaid crisis, by seeking approval from Washington for a variety of changes. "Today is not about cutting Medicaid," she said. "... It's about protecting the future of Medicaid."