TribBlog: "Older and Sicker" [Updated]

After Thursday's lively state hearing, where health advocates told lawmakers they were bracing for massive Medicare cuts, doctors got some rewarding news: Congress had voted to delay a 21 percent cut in Medicare payments six months.

The bill is headed to President Obama for a signature. But even with Obama's signature, the measure is only a temporary fix. Tim Graves, CEO of the Texas Health Care Association, told lawmakers on Thursday that the Medicare cuts expected to accompany federal health care reform could affect their elderly charges. 

"Specifically on health care reform, I don't think anybody really knows how that's going to work," he said.

Graves testified at the third meeting of the Joint Legislative Committee on Aging, formed last year as the health care debate in Washington intensified. On Thursday, he and representatives from assisted living, adult day care and hospice organizations met with the committee as it prepares to make recommendations for the upcoming legislative session.

Greg Lentz, chair of the THCA board of directors, said the cuts come in the context of a changing health care landscape: Residents in Texas nursing homes are living eight to 12 years longer than they were a decade ago and have more daily needs. As committee chair state Sen. Eddie Lucio Jr., D-Brownsville, characterized it, "your residents are getting older and sicker than before."

Some residents are ending up in hospitals rather than nursing homes as a result, Lentz said. And rural communities have been hit hard by funding issues: A third of facility closures since 2006 were in rural parts of the state, he said.

The testimony met sympathetic ears on Thursday from Rep. Susan King, R-Abilene, a nurse, and Betty Streckfuss, a retired health care provider from Spring who serves as a public member of the committee.

King, whose husband is a doctor, said perceptions of physicians as "grim reapers" if they refuse to treat elderly Medicare patients are unfair — particularly in the wake of the anticipated 21 percent cut in physician Medicare payments.

More Texas doctors have stopped accepting Medicare and Medicaid patients in the past decade, calling it a losing prospect for their bottom lines.

Streckfuss took the most direct aim at the federal government on Thursday as she delivered what she called a "plea" to fellow committee members to pay attention to aging Texans' health.

"Only those guilty of turning their backs on our needs will be haunted," she said.