The Coming Texas Medicaid Storm/ repost by requests

[Guest guest]

Several readers have asked me to repost the Medicaid article:

The Coming Texas Medicaid Storm

by Scarborough

These are hard and turbulent economic times. Many families have

lost jobs or know a friend or a family with a child with a

disability that has fallen through the countryÕs economic cracks.

These uncertain economic times have hit families with children

with lifelong disabilities especially hard.

I have seen recessions come and go over the last 3 decades in my

work as an advocate through the National PASS Network, but I have

not seen things as desperate for families as they are becoming

now.I wish I could say brighter days are ahead, but that would

not be true. As my wise grandfather used to say, Ó there is a

big storm headed our wayÓ. We all ought to be worried.

One of the real lifelines for services and medical support for

families with children with severe lifelong disabilities is

access to the state administered Medicaid programs. Medicaid

never has been easy to get in Texas because of the bureaucratic

hurdles that the state government has created on purpose to

reduce access. You can be sure that Medicaid will even become

harder to get in the coming months as the Texas Legislature

convenes and deals politically with the projected $25 billion

state budget deficit.

As the Legislature tries to balance the state budget without

increasing state revenues only one thing can really happen: state

budget cuts that will wipe out entire beleaguered state social

service agencies and cut programs that families need and have

depended for years to unsustainable levels.

Many Texans with disabilities and their families are already

being affected by these budget cuts, and many, many more will be

affected in the next legislative year. I saw projections the

other day that some 13,000 people will lose their access to the

Medicaid waivers. The Òwaiting listsÓ can only grow longer and

become just another sick Texas government euphemism for denial of

care.

Right now in Texas there are ONLY TWO WAYS to get Medicaid for

children with severe disabilities. The first is through the

federal eligibility for SSI. This is called Òcategorical

eligibilityÓ and at least one dollar of SSI eligibility brings

full Medicaid coverage. This approach CANNOT be changed at the

state level by state politicians looking for an easy way out of

budget problems they have created. It is federal law.

Most families get Medicaid through a second route though, the

community-based waiver programs. Sometimes this is the only way

to access Medicaid for a child. These programs are OPTIONAL state

budgetary items and the have a waiting lists to get the

community-based care. The waiting lists are measured in decades

as the programs are already rationed out. Families may

eventually get on the Medicaid waiver programs and then they

ÒforgetÓ about applying for the SSI categorical eligibility when

their child becomes SSI eligible. ÒItÕs to much trouble; I

already get MedicaidÓ is what I often hear. In the changing Texas

Medicaid budget dynamic this Medicaid eligibility approach is

about to become fatal for your childÕs needs.

Sooner or later a child with a severe disability can receive SSI

and Medicaid. ItÕs usually at 18, but it can be earlier

depending on the families income and circumstances. A parentÕs

challenge is to know when, how and what to what do to make this

happen sooner rather than later. Parents also need how to keep

SSI/ Medicaid once they get it and not inadvertently lose

eligibility because of some Social Security bureaucratic

flimflam. Parents also need learn to maximize the benefit, rather

than receive the least amounts. It is an consumer education

responsibility on the part of a parent of a child with severe

disabilities. Optional Medicaid programs are just that: optional.

If the Texas Legislature feels they need to be cut these programs

in the next session, there will be no political consequences for

them to do so. To make matters worse, Governor has been

talking about completely opting Texas out of Medicaid program

altogether(as though he could really do this).

Texas already has had the highest rate of uninsured children in

the nation for past 10 years decade, according to the latest Kids

Count report of the Annie E. Casey Foundation Texas. I call the

Texas LegislatureÕs upcoming Medicaid deconstruction our ÒRace to

the BottomÓ. ThatÕs not saying very much because Texas is ALREADY

at the bottom. Really Texas opted out of substantial support for

children and adults with disabilities a long time ago.

The National PASS Network in moving into its 29th year of

providing assistance to families to understand how to access the

Social Security disability benefit programs. Our Fall Parents

Saturday Workshop ÒAccessing Social Security Disability Benefits

to Provide Opportunities for Self-Support for People with

DisabilitiesÓ is in a week or so on November 20 at the Arc of

Texas Headquarters. Sign up today! Given the political winds

swirling around Medicaid access, this workshop may be exactly

what you will need.

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Registration for the November 20 workshop has ended, but if

you would like to receive an email notice for the next Parents

Saturday Workshop, send us an email indicating your interests.

Check out these workshop notices:

Online Workshop Brochure http://bit.ly/NPNWksp

Agenda http://bit.ly/NPN-Agenda

Scarborough

President

National PASS Network

dscarborough@...