Naked City

A coalition of urban state senators, including Gonzalo Barrientos, D-Austin, has urged the Health and Human Services Commission to put the brakes on the rollout of the Star+Plus HMO to all urban areas of the state, which could bring $109 million in savings to the state but $150 million in losses to the state's nine public hospital districts. The move, part of last session's HB 2292, would shift 2.6 million Medicaid patients into a managed care network. Like many measures in HB 2292, which consolidated the state's health care agencies, the initiative sanctioned both privatization and cost-savings. The state's gains, however, are balanced by local losses. For Brackenridge Hospital and the Travis Co. Hospital District, that means $9 million in losses over the next biennium.

Sen. Royce West, D-Dallas, asked the HHSC to weigh the Medicaid HMO issue more carefully in a Tuesday news conference, where most of the urban senators joined him. Short-term gains sometimes aren't worth the long-term implications, West said. And the senators said they had a hard time verifying the savings proposed by HHSC. "We have met with health care and county officials all over Texas, and they are in agreement that the proposed changes could have a drastic negative impact that reaches far beyond the next biennium," West said. "While the Commission has been charged with implementing the most cost-effective solution to indigent care, the harm caused to public hospitals may far outweigh any short-term state savings."

At a session of a House Appropriations Subcommittee meeting earlier this month, Health and Human Services Executive Commissioner Albert Hawkins explained that money could be recouped through other federal funding sources, a point that has been met with some skepticism from public hospital district administrators and state lawmakers. Sen. Leticia Van de Putte, D-San Antonio, said lawmakers should be skeptical of the numbers. A lot of the numbers presented last session have turned out not to be correct, including the implications of the vote on the Children's Health Insurance Program, which led the state to leave federal money on the table.

The Tuesday news conference came as an early shot over the bow. Hawkins was scheduled to address a Finance Committee workgroup headed by Sen. Judith Zaffirini, D-Laredo, at the end on the week. He will also return to the House Appropriations Subcommittee. "We look forward to his testimony," West said, "so we can get the whole picture and consider all the alternatives being proposed and talk about the dollars."