A group of Plaintiffs, comprised mainly of families with disabled children and their healthcare providers, sued the department of Health and Human Services for acting outside of its legal authority.
In Part 1, we talked about how the budget is created and why the legislature is considering cuts to Medicaid. In Part 2, we will discuss the lawsuit against the Medicaid cuts.
The lawsuit is centered on the proposed cuts to Medicare which could potentially reduce access to healthcare for struggling families.
The plaintiffs claim Health and Human Services never fully considered the impact the cuts would have on disabled children. The state had commissioned Texas A&M to conduct a study comparing what Texas pays for Medicaid services to other states. However, this Texas A&M’s study focused solely on money that could be saved and did not include any information on access to care, making it biased towards supporting the cuts.
The judge issued a temporary injunction beginning September 25, 2015 preventing the Health and Human Services Commission from implementing the budget cuts until the trial was conducted on January 18, 2016.
The injunction has since been extended to prevent any cuts from taking place while the case was being appealed. The Texas 3rd Court of Appeals ruled the lawsuit invalid in April, thus ending the injunction. The plaintiffs are planning to seek intervention from federal regulators. The cuts are scheduled to begin July 15th.
Opponents of the cuts say an estimated 60,000 Texas children will be cut off from “medically necessary services”.
The families of these children will turn to already over-burdened community centers and require assistance in other forms to make ends meet. For many childhood disabilities, lack of treatment now can lead to serious complications (and more expenses) down the line. Providers of speech, physical and occupational therapies will be hit the hardest. Therapists face up to a 20% reduction in payment, enough to put many practitioners out of business. This possibility is a very serious problem for disabled children in rural Texas where healthcare will not only become less affordable, but families may also need to travel further for treatment.
The budget cuts have been lambasted in the media.
But they had overwhelming support in both the House (115-33) and Senate (30-1). Proponents of the cuts say that Texas pays way too much for Medicaid services compared to other states- up to three times as much in some instances. The services being cut cost $436 million in 2009, but $722 million in 2014- an increase of $286 million.
Superior HealthPlan told the judge that cuts will not stop them from providing children with the services they need.
The insurance provider claims to have studied the cut independently and believes there will be “adequate access to the network”. Those supporting the cuts believe the therapy providers are overcharging the state; the home health companies are currently over-paid and the cuts will simply put them in line with the national average.
The lawsuit may have been dismissed, but the fight is not over. The Health and Human Services Commission will begin implementing the cuts in July.
In the meantime, opponents of the cuts are attempting to get the Federal government to intervene. Health and Human Services Commissioner Chris Traylor has promised to work to preserve access to care, however many service providers believe that will not be possible.
Unfortunately, about a quarter of people will become disabled during their working years. If an injury or illness is preventing you from working, you may be eligible to collect disability benefits. If you are thinking of filing for social security or long term disability we can help. If you have filed for benefits and been denied disability we can assist in your appeal. Don’t give up. Contact the experienced long term disability attorneys at Bemis, Roach and Reed today for a free consultation. Call 512-454-4000 and get help NOW.
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