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The Trib interviews Garnet Coleman

The Trib has a too-brief conversation with State Rep. Garnet Coleman on health care and Medicaid. This is the crucial bit:

TT: What do you want out of this meeting with [the Center for Medicare & Medicaid Services]?

Coleman: Two things. One, it’s important that we extend the enhanced FMAP (the Federal Medical Assistance Percentage, or the percent of Medicaid expenses the feds cover — which was enhanced with stimulus dollars to meet the national recession). That would help every state accomplish its goals in terms of dealing with what a recession causes, and the ability to balance their budgets, and it’s a simple fix. [The FMAP ratio is] still 70-30, federal to state, with the enhanced match. The goal is to continue the enhanced match past when it expires in June.

TT: How much would that help Texas alleviate its budget shortfall, estimated at between $15 billion and $27 billion?

Coleman: I worked really hard, and so did other members from across the country, to get that enhanced match, which gave Texas $850 million in real general revenue savings the first time around. If we had that for another year, we would get approximately $2.5 billion in savings. If we had it for another two years, we’d have approximately $5 billion in GR savings. And so this is extremely important. The other piece is, in terms of Medicaid in general, and the use of Upper Payment Limit, or UPL funds (federal funds paid to hospitals to bring Medicaid reimbursements up to Medicare levels), under the current rules, you can’t have a statewide managed care program and get UPL. And then if you did have that managed care system, you’d have to carve out hospitals. The question is whether the federal government will approve [allowing managed care programs to participate in UPL]. I went up in December to have a conversation about that, and I’m going to revisit it with [Deputy Medicaid/Medicare Administrator] Cindy Mann in her office about that.

That sure would make a dent in the budget shortfall, no? It would certainly be nice if our legislative Republicans and our Congressional Republicans got together to help make it happen. Assuming that finding constructive solutions to these problems interests them, of course. In related news, some of those legislative Republicans and our Lite Guv got together with one of the local slash-and-burn interest groups to push some unworkable alternatives for Medicaid. Rep. Coleman points out all of the problems with their approach here.

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