Jan 12, 2018 in Law

Government 2306 Texas Politics: Memo to Texas Governor

The policy of the states is directly correlated with the acts issued by the federal government. Consequently, the policy of every state is defined by the main directives of the head government.

The decision concerning state policy can hardly be overestimated. Thus, the national problems have to be solved on the state level. One of the greatest concerns which have to be addressed in the policy is Health care system. During the First Called Special Session of the 82nd Texas Legislation in the year 2011 the healthcare issues were neglected. The $4,8 billion hole in Medicaid  was not addressed  by lawmakers. The funding of Texas Health Human Services had 17,2 percent reduction of funding. Additionally, there was a 10 point decline in the Federal Medical Assistance Percentage. Moreover, the decrease of funding equaled 23 percent, which is $ 57,5 million each year since 2011. Further reductions tackled inpatient and outpatient hospital funding (House Bill 4 and senate Bill 275).

HealthCare.gov writes in the article “How the health Care Law is Making a difference for the People of Texas” of April 1, 2013 “For too long, too many hardworking Americans paid the price for policies that handed free rein to insurance companies and put barriers between patients and their doctors.

Noam N. Levey, Los Angeles Times  writes “…in the 11 years the Republican presidential hopeful has been in office, working Texans increasingly have been priced out of private healthcare while the state's safety net has withered, leaving millions of state residents without medical care” (Levey, 2011).

The Affordable Care Act was adopted on the federal level. In accordance with it the health insurance coverage will create a Health Insurance Market in every state.

It is highly advisable that Texas takes part in the Medicaid expansion as it will enable many individuals to obtain health insurance. Joining the Medicaid expansion is important as the insurance coverage will be provided for the poorest Americans. Those whose income is less than 133 percent of the federal poverty level  will be given the opportunity to get insurance beginning from the year 2014.

Health and Human Services Commission was transferred into the Texas integrated Eligibility Redesign system. It was aimed at making an easier access to the information. At the same time, there are problems of the Healthcare system which require governmental decisions to be implemented in the state policy.

Section 2306.002 Policy of Texas Governmental Code states that the state has to provide safe and affordable living environment and individuals of low income have to be assisted at all levels. At the same time, the main priority of the government is claimed to be assistance of individuals and families with low income  through governmental programs:

The highest priority of the department is to provide assistance to individuals and families of low and very low income who are not assisted by private enterprise or other governmental programs so that they may obtain affordable housing or other services and programs offered by the department (§ 2306.002. Policy). 

However, the above-stated claims do not find their realization in the policy. The main purposes of current policy are based on the reduction of costs. Furthermore, the Texas government is entirely focused on the fulfillment of the federal directives.

Therefore, many concerns aroused by implementation of the eligibility system.

One of them is connected with soon expiration of the Affordable Care Act which served to modernize the eligibility systems. The fiscal impact on the health and Human Services budgets of the 2016-2017 biennium is threatened by the end of the enhanced match for modifications to the Texas integrated Eligibility Redesign System

It is necessary to stress that the policy of the current year and the year 2013 is based mainly on the HHSC Strategic Plan for the years 2013-2017. The key introduction is the implementation of the self-service functions. It is presented in the form of web-based technologies which enable clients to access online information. The positive outcomes of this system include management of client cases outside regular office hours, reduction of the amounts of work overtime (www.lbb.state.tx.us).

According to the Affordable Care Act of the year 2010, the Medicaid eligibility process has to be streamlined. The main task of the state is to modernize the eligibility systems and after that receive the enhanced Federal Financial Participation rates. It means the establishment of the data sharing compatibility with other systems of health Insurance Exchange.

Additionally, HIX is created in order to enable residents to choose most appropriate health plan. The U.S. Office of management and Budget issued the waiver which allows states to obtain 90\10 (federal/state) match ratio.  This will provide opportunities through such federal programs as SNAP that is Supplemental Nutrition Assistance Program, Temporary Assistance for Needy Families (TANF), Children’s health Insurance Program (CHIP).

One of the assignments is the expansion of the TEXS Medicaid program, which is impossible without an increase in eligibility determination caseloads. In order to perform the exchange of eligibility information between state federal and private HIX the technologies have to be implemented. 

It is planned that the new functionality will be achieved through the use of the current income assessment methodology and a modified adjusted gross income (MAGI) technology.  In this connection, it is necessary to point out that the implementation of the MAGI methodology does not take into consideration the fact that there is a 5 percent federal poverty level.
            Additionally, there are further difficulties in connection with implementation of the methodology in the year 2013 which include necessity to provide phone, computer, mail and in-person application options. Furthermore, other challenges include the need for financial and human resources, safe delivery of digital services, which would protect personal data, use of electronic data for eligibility verification etc.

Taking into consideration all the challenges and difficulties, which have to be overcome in order to successfully implement the eligibility system it is of importance to make amendments to the current policy.

The changes have to be done in accordance with the above-mentioned challenges and will require supplementary budget costs.

Another issue to be highlighted is The Star+Plus Services programs. The main purpose of the program is connected with coordination with the MCO for providing long-term services for patients. Beginning from March 2012 the carving for clients with disabilities health inpatient hospital and prescription drugs is done by care rates for Star+Plus. Star+Plus offers such benefits as a waiver of the 30-day spell-of-illness limit and a waiver of the three prescriptions. Its main aim is to assist low-income citizens.

It is of importance to make amendments to the current policy taking into consideration the fact that poor citizens need governmental support. There is a lack of programs aimed at the need of such category of citizens in Texas. The focus of the reduction of the cost will increase the number of existing problems in the sphere of Health care.

It is advisable that additional insurance plans are added to the health care law. The coverage has to be given for all preventive health services as this is the key to the health of the whole nation. Additionally, seniors and disabled have to get possibility to be health by getting free detecting health services.

One more challenge to be addressed by the policy is  by supporting those who live in urban, rural and frontier communities. Educational loans and scholarships are important for the development and increase of the quality of healthcare services.

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