I suspect that for too many members of the incoming Legislature, the decisions they’ll be making about the budget will be ones they’re not at all uncomfortable with.
The Legislature’s Republican leadership will confront weighty questions, such as how many children the state can afford to provide medical care for and what level of care and supervision can be provided for the elderly and disabled.
At lawmakers’ elbows will be the chief of state social services, Tom Suehs. He predicts an agonizing process.
“There are not too many nice and easy decisions,” he said recently. “That’s why they’re going to migrate to cutting some of the optional” services in Medicaid, a health program covering 3.3 million poor children, pregnant women and frail adults.
But Suehs (pronounced “seas”) is quick to add that optional services – which can be taken away from adults on the program, though not from youngsters – are not frills. Cuts will be costly and painful.
“I want to do a better job of describing the balloon effects,” he said. “If you squeeze the community mental health, you’re going to end up possibly with more people in prison, and that’ll cost money over there.”
Suehs’ task is to help lawmakers understand the implication of life without optional Medicaid coverage for hundreds of thousands of Texans who have little other choice.
Among the services the federal government does not require states to provide: prescription drugs, hospice services, kidney dialysis treatments, hearing aids, mental health treatment and eyeglasses.
A Dallas Morning News analysis found that the state would save about $1 billion in state funds over two years by eliminating all six services for the 820,000 adults now enrolled. That’s less than 5 percent of the savings needed to bridge the overall deficit.
“You want to cut drugs to old people? That’s optional,” Suehs said. “You want to cut out kidney dialysis treatments? That’s optional.”
Our elected Republican leaders could, of course, choose to fund these things if they wanted to. But that might mean asking Dan Patrick to pay a few extra dollars in property taxes, and Lord knows we can’t afford to do that. So all you sick and dying people that will need to sacrifice for the greater good of the state, please be dears about it and do so quietly. Thanks very much.