Another Voice on Medicaid Cuts

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Ron Payne is the chairman of the Texas Health Care Association board of directors. He also characterizes himself as a lifelong conservative Republican. On 6/16/17, Mr. Payne wrote an editorial piece for the Houston Chronicle concerning the failure of the Texas Legislature to provide adequate Medicaid funding for Texas nursing homes.

According to Mr. Payne, about 2 of every 3 Texas nursing home residents rely on Medicaid to pay for their care. The reimbursement rate is set by the Legislature and is among the lowest in the nation. The rate, according to Mr. Payne, does not come close to meeting the cost of caring for Medicaid residents by the state’s own estimates. Of course, this means that those not relying on Medicaid have to make up the difference.

The result of chronic under-funding is, Mr. Payne states, “…nursing homes are not able to offer competitive wages,” which makes it “hard to recruit good, quality nurses and nurse assistants, and is why our annual staff turnover statewide averages more than 90%.”

In 2015, the Legislature refused to raise Medicaid rates despite a $7.5 billion surplus.

In the session that just ended, the Legislature refused to allow nursing homes to access federal funds through a program used in 43 other states even though participation would not have expanded Medicaid. In other words, the Legislature knowingly chose to under fund nursing homes even though it didn’t cost Texas taxpayers. According to Mr. Payne, too many legislators “thought people might accuse them of voting for a “granny tax” and that certain political groups might attack them for not being conservative enough.”

Having represented many families over the years in nursing home negligence and abuse cases, I can assure you that the root causes of most injuries and deaths in nursing homes are inadequate staffing, poor education and training, lack of experience necessary to acquire skill, and lack of supervision. Injury and death are the predictable results of a workforce that turns over at a rate of over 90%

It seems more than a pity that battles over ideological purity should take precedence over care of the elderly.