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Rep.Coleman, Garnet F.

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Statement from Rep. Coleman on the Medicaid Reform Proposal by TPPF 
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by: Rep. Coleman, Garnet F.
02/22/2011

Austin--State Representative Garnet F. Coleman (Houston) released the following statement in response to the Medicaid reform proposal released by the Texas Public Policy Foundation:
What we've seen this session are two different proposals to control costs for Medicaid. First, Governor Dewhurst and other leaders have proposed real solutions that focus on payment reform and controlling costs while delivering quality care to our seniors and children from working families.

Unfortunately, others are pushing unworkable solutions based on alternate realities and political ideologies that ignore the needs of the state and the material truths of public policy.

We can choose to lead Texas with responsible public policy or become mere supporting actors in a national political sideshow.

The TPPF plan recycles three methods to accomplish its goals, none of them tenable:

1) Through an Interstate Compact
The interstate compact proposal will not work because Article I of the U.S. Constitution holds that interstate compacts must be approved by Congress, and, since this particular interstate compact in essence tries to nullify federal law, Congress assuredly would not approve it.

2) By shuffling Medicaid beneficiaries into the private market
Putting Medicaid beneficiaries on a private exchange has already been tried, notably with Indiana’s Healthy Select Plan, which has proven to be bad fiscal policy.
http://www.chron.com/disp/story.mpl/editorial/outlook/7304201.html
“There is no evidence that Healthy Indiana beneficiaries are getting better care than Medicaid beneficiaries. However, the care they are receiving costs more, and leaves less for reimbursing uncompensated care for the remaining 95 percent of the uninsured.”

3) Through a waiver
Governor Perry’s last waiver request was not approved by either the Bush Administration or by the current administration because it was not “a feasible option.” Waivers are granted to states seeking new ways to pursue the stated goals of Medicaid, not for states wishing to lower quality and access, which this waiver would do. Moreover, these waivers must be approved by Health and Human Services Secretary Kathleen Sebelius, who has been consistent in her position that the goal of health reform is to increase access and quality. Therefore, a waiver that would stand in the way of these goals would be dead on arrival.

Conclusion
Ultimately, these ideas combined with earlier proposals to move to a Medicaid block grant are fiscally irresponsible. Moving to a Medicaid block grant would mean we’re capping the federal funding we receive and in turn could have to increase state spending for lower quality care as our population increases.

Representative Coleman is available for comment.

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