Tuesday, March 07, 2006

More "I Told Ya's" -- Medicaid in a Tailspin in Texas

Like CHIP, Children's Medicaid sees enrollment decline
3/7/2006 8:14 PM
By: Associated Press

The number of Texas children insured by Medicaid has dropped by nearly 79,000 since November.

The drop mirrors enrollment losses seen in the Children's Health Insurance Program, which is for kids whose families can't afford private coverage.

About 1.76 million children were enrolled in Medicaid last month, down from 1.84 million in November, according to the Center for Public Policy Priorities.

State officials say the Medicaid decline appears to be related to staffing problems at eligibility offices.

Advocates, however, blame the decline on the contractor that recently started processing benefits applications.

The Texas Health and Human Services Commission said the new contractor did not begin handling applications until January, after the decline began.

My Comment:

That may well be, but the decline is happening -- not because the need has gone down, but because the old system is being gutted, while the new system is not working yet -- and shows no signs of working any time soon.

It may well be that the new system may one day be made to work -- though I doubt it. But the transition plan to the new system never could have worked, and was doomed from the start.

They should have maintained the old system at the staffing levels needed to keep that system up and running, and then implemented a pilot for the new system, and then slowly brought up the rest of the state... after ensuring that it was working and was really cost effective, and able to deal with the workload. Only as they began to see the new system working in the real world, should they have begun downsizing the old system. With this approach, if you saw that the new system was flawed, you would have the option of scrapping it, or modifying it. HHSC has already destroyed the old system. It would take years to rebuild it, even if they began tomorrow.

The "staffing problems" are what you get when you have a 5 year hiring freeze, followed by handing out pink slips to most of your staff, informing them that they will not have a job when the new system is implemented. This was not only foreseeable -- it was planned. But here they act as if it snuck up on them.

Many working poor people, and even many people who are lower middle class depend on Medicaid at least some of the time. And when they need it, they need it. You will be seeing more and more articles about how people who need it, can't get it, because the system (both the old one that is being gutted, and the untried new system that is supposed to be coming on line) cannot deal with the workload.