Texas and the Poor, Part II

Some years ago, The Texas Legislature began an ill fated journey to make Medicaid more difficult to access, more difficult to keep and more difficult to use. I was in one of the state-wide hearings that was really a state-wide show (probably paid for by the poor). Billed as a "listening session" the Legislature had already made up their minds.

First, they were going to close most of the local human service offices. (This is where the ideas go from the stupid to the ridiculous) In their place there would be three ways to access Human Services in Texas. First would be over the internet. Now the last time I looked, few poor people could afford computers or internet connections, but that was beside the point. When this objection was raised, those in the audience were told that internet sites were available everywhere: public libraries; internet cafes, etc. Second, people could access Human Services through a call center. Generally that means an outsourced answering system that does not understand anything but the basics of what they are dealing with. Picture an Bombay answerer and a Hispanic person at the other end. That would grind things to a halt. Finally, people could access Human Services through a bus that would visit the community on a published schedule.

Next, for the benefit of the Medicaid users(yea, really) enrollment would be required every six months. This was to keep addresses current, deter fraud, and other reasons that escape me.

Finally, Texas would outsource its paying to a third party payer. Now, I am not the smartest pencil in the pack, but if there is not enough money to go around and you want to get the best bang for your buck, why would you pay someone to do what you already pay employees to do? And where is that money going to come from? The Legislature's answer: from the savings that come from better management. What that translates into is simply savings that come from making Medicaid out of reach for most of the people.

Additionally, when you make reimbursement low enough and slow enough, physicians and other providers will give up in despair and quit taking Medicaid. Problem solved. When there are no providers and people have to chase the bus to renew their Medicaid, your net result is great savings.

I told you, Texas hates the poor.

P.S. Three to five years into this Legislative scheme, it was quietly abandoned because--IT WOULDN'T WORK!!!! I believe that is what the hearing kept telling the panels that criss-crossed Texas.