Kids with disabilities being hurt by $350 million cut in Medicaid
AUSTIN — Stacey English has modest desires for her 7-year-old daughter Addison: Be able to eat without gagging and move both her arms.
But since Addison’s occupational therapist went out of business this winter, the child with a rare genetic disorder has regressed in her fight to do even that much.
“I don’t know where to go from here,” said English, who has been unable to find a replacement therapist in their town, College Station. “How do you continue to help her make progress when you don’t have someone to teach her?”
Some Texas children with special needs like Addison have lost critical services since December when the state implemented $350 million in Medicaid cuts to speech, occupational and physical therapy. In Texas, reimbursement offered to providers fell up to 50 percent for certain therapy procedures, said Rachel Hammon, president of Texas Association of Homecare and Hospice. Clinics closed and therapists quit. More cuts possible
The Texas cuts are separate from Republican proposals now before Congress, which academics say could cut federal Medicaid spending as part of a law to replace the Affordable Care Act. But the fallout could eventually be similar if some form of what’s been approved in the U.S. House, and is under consideration in the Senate, becomes law, said Elizabeth Burak, the senior program director of Georgetown University’s McCourt School of Public Policy’s Center for Children and Families.
The Texas Legislature voted in 2015 to cut the state’s Medicaid reimbursement for pediatric acute therapy services, which effectively capped how much providers can be paid. Proponents of the cuts argued that Texas’ previous reimbursement rates were too high, sometimes even encouraging fraud.
In a 2015 letter, Lt. Gov. Dan Patrick and state Sen. Jane Nelson, the chamber’s chief budget writer, argued then costs for acute care services to Texas’ Medicaid program had risen 66 percent in the five years from 2009 to 2014. They also said nearly one in seven of the state’s Medicaid legal sanctions cases for fraud were for therapy providers. Some funds restored
Relatives of children with disabilities and providers sued unsuccessfully to block the cuts. Republican House Speaker Joe Straus vowed to restore the lost funding during this year’s legislative session, which ended May 29 — though lawmakers eventually approved a budget replacing only about a quarter of what was cut.
Texas’ Health and Human Services Commission hasn’t yet seen a drastic decrease in therapy providers because of the cuts, said spokeswoman Carrie Williams.
She said three agencies terminated contracts with Medicaid networks for that reason and “all clients are receiving assistance finding new providers.”
Providers say that since Texas’ cuts, they’ve struggled to stay financially afloat.
“I couldn’t get any therapists to keep working for me who were registered or licensed,” said Kathi Strawn, owner of Therapy Options Texarkana. She closed her clinic June 1.
Hammon said Texas has no accurate way of tracking children deprived of services, calling them “the hidden victims” in the Medicaid cuts. Children relying on home care therapists have the most severe disabilities, and those agencies have been hit hardest, she said.