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Double secret illegal Medicaid amendment amended

Yes, I know, it’s all so confusing.

It's constitutional - deal with it

It’s constitutional – deal with it

The House on Sunday night accepted Sen. Jane Nelson’s and other lawmakers’ clean up of an amendment by a freshman state representative from Collin County that would require a rubber stamp from the Legislature before Medicaid could be expanded to cover more able-bodied adults.

Basically, they feared Rep. Jeff Leach’s provision could screw up two things — some shifts of the state’s most disabled individuals between so-called “Medicaid waiver programs,” as the bill attempts to improve and shrink the cost of their long-term care services; and the scheduled addition to Medicaid of foster children through age 26 and a subset of youngsters now on the Children’s Health Insurance Program. Under the federal health care law, some current CHIP recipients — those ages six through 18 and just over the poverty line — will have to be shifted to Medicaid. That and the extension of coverage for former foster children are noncontroversial requirements of the federal health care law.

The long term care bill, which would expand use of managed care in Medicaid, received final House approval and was finally sent to the governor. The vote was 146-1.

Last week, Leach, R-Plano, added the provision to the measure by Nelson, R-Flower Mound. Effectively, it would have barred the Texas Health and Human Services Commission from accepting anyone into Medicaid who was not eligible under this year’s rules as of Dec. 31. Leach said he wanted to make sure lawmakers, not just Gov. Rick Perry, have a say on whether Texas expands Medicaid to cover uninsured adults of working age. Texas currently covers almost none.

Rep. Richard Raymond, a Laredo Democrat who was House sponsor of Nelson’s bill, said the new language added by House-Senate negotiators makes sure Leach’s amendment does no collateral damage.

“We have been able through the years to get waivers” for disabled and elderly Texans to stay out of nursing homes and large group homes, he said. But the bill will put those services under managed care, he noted.

See here for the background. Basically, the committee report clears up the aspects of Leach’s amendment that could have caused real problems, and leaves the largely symbolic “do nothing without the Lege’s OK” provision in place. As I said before, it’s not like Medicaid expansion is going to happen without major changes to the state government, if it ever does.

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