Legislature opts to largely maintain cuts of therapy services for disabled children

In the latest showdown between the Texas House and Senate — this time over how much money to spend on speech, physical and occupational therapy services for disabled children — the Senate scored a last-minute victory.

State Rep. John Zerwas, R-Richmond, told House colleagues on Friday he was prepared to accept the Senate’s version of a stop-gap budget plan, which would not restore funding for disabled children’s therapy services that House leaders had previously pledged to reverse.

Disgruntled House lawmakers gathered at the back microphone to express their disappointment as Zerwas delivered the news to the chamber. 

“It seems like we’re not doing near as much as I think Democrats and Republicans in the House wanted to do to reverse these harmful cuts,” said state Rep. Chris Turner, D-Grand Prairie.

“We couldn’t find that money elsewhere in the budget to fully restore these cuts?” asked state Rep. Rafael Anchia, D-Dallas.

Zerwas said it was the best deal he could negotiate after receiving a “tremendous amount of pushback from my Senate colleagues on this.”

“I just don’t have any ammunition left,” he added.

The disagreement traces back to a decision by the Legislature in 2015, pushed by Senate Republicans, to cut the amount of money that speech, physical and occupational therapists are paid by Medicaid, the federal-state health insurance program for the poor and disabled, when they treat children with disabilities.

The $350 million funding cut outraged therapy providers and the families of children who receive their services, and a group of concerned Texans quickly filed a lawsuit seeking to block the cuts. They lost, but the legal maneuvering tied up the budget cuts in court for more than a year.

In the meantime, dozens of House lawmakers from both parties came out in opposition to the budget cut. With state health officials on the verge of implementing the payment cut last year, House Speaker Joe Straus vowed in November — just a few weeks before the start of the 2017 session — to restore some of the Medicaid funding.

“It did not work, and it will be addressed in the supplemental budget,” Straus said at the time. He said the cuts were “well intentioned,” but “maybe they were a mistake.”

The supplemental budget is a routine measure used by state lawmakers during the legislative session every two years to plug funding holes leftover from the previous session. Most sessions, the Texas Legislature does not fully fund the cost of state programs, so lawmakers must typically pass a supplemental bill to cover the rest.

This year, the biggest difference between the House and Senate’s supplemental budget proposals was whether to restore the therapy funding. Senate budget writers unanimously approved $1 billion in state funds to pay for a supplemental budget earlier this month, agreeing with the House on many points, but not on the issue of therapy funding.

Still, in the next two-year budget, Zerwas noted, the House and Senate reached an agreement that will give therapy providers a 25 percent restoration of their Medicaid payments in 2018 and 2019. House lawmakers, Zerwas said, could consider that a small victory in the fight over therapy payments, indicating that Senators accepted the payment restoration only grudgingly.

“I would say that both sides feel equally disappointed about where we are,” he said.

The House voted 115-21 to accept the Senate’s version of the supplemental budget, with many House members defending their vote as being the least bad option available to them.

“I think it’s a travesty what the Senate has caused to happen,” said state Rep. René Oliveira, D-Brownsville, shortly before voting yes.

On Wednesday, in a public hearing before the Texas Health and Human Services Commission in Austin, around 175 people testified that the proposed Medicaid cuts in 2015 would jeopardize their disabled children's access to health care services. Families said they feared their therapy providers would no longer be able to afford to treat Medicaid patients if the state reduced their payments by as much as 25 percent.

Linda Litzinger said her daughter, Amy, who has cerebral palsy and quadriplegia, wouldn’t be where she was today without the therapy she received growing up.

“Part of what people assume is happening through therapies is people don’t have issues with their disability anymore,” Amy Litzinger said. “And in my case, I still have [cerebral palsy] and quadriplegia. In my early developmental stages, any increment I could gain skills and maintain them was good. I can’t cook, but I can feed myself. I can maintain balance with the right equipment; it’s not walking, but I’m functional.”

Litzinger asked the panel how much funding they believed Texas could strip from the therapy business and still expect successful results. “You better think twice,” she said, “or you’re going to lose a lot of children in Texas.” 

Cassandra Pollock contributed to this report.