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How Rural Hospitals Might Suffer Under New Medicaid Waiver

Photo via (CC BY-NC-ND 2.0)

In December the state secured a waiver that would pump funding into hospitals in Texas. But as Chris Collins writes in for the Texas Observer, the deal might end up being bad news for Texas hospitals, especially those in rural parts of the state. He spoke with Carlos Morales about the article.

The 1115 Medicaid waiver, Collins says, allows Texas to operate Medicaid programs in different ways. "Functionally, one of the really important things it does is it provides is funds and it allows Texas to expand its private managed care system, which we're doing instead of expanding Medicaid through the Affordable Care Act."

The waiver provides some $25 billion to hospitals.But under revisions to the deal that funding would be slowly phased in the coming years.

Collins says that fine-print detail has rural hospital advocates concerned. "[It's] going to disproportionately affect rural hospitals because they're funding streams are already so precarious as it is without any additional reductions in fundings."

The funds that will be reduced or phased out, Collins says, help cover two key areas for hospitals. One helps pay hospitals back for "Medicaid shortfall," which is the difference between the cost for hospitals to give Medicaid service and what Medicaid normally pays the hospital back.  The other funding at risk is for innovative projects that hospitals have undertaken.

You can read Chris Collins article on the waiver at the Texas Observer's website.



Carlos Morales is Marfa Public Radio's News Director.