| Texans ask Bush for Medicaid help State wants more funding, flexibility 04/06/2001 By Charles Ornstein / The Dallas Morning News
WASHINGTON – Faced with surging state spending on Medicaid, Texas legislative leaders appealed to President Bush on Thursday for more federal funds and greater flexibility to run the program as they see fit.
Texas health officials expect Medicaid costs to rise by up to $620 million in the next two years just to maintain the current level of services. And the state already is tackling a deficit of about $590 million in the two-year budget cycle that ends this August.
Acting Lt. Gov. Bill Ratliff, a Republican, and House Speaker Pete Laney, a Democrat, outlined their Medicaid problems during a meeting and White House tour led by Mr. Bush. They were joined by Rob Junell, House Appropriations Committee chairman, and Rodney Ellis, Senate Finance Committee chairman, both Democrats.
The four men later met with Tommy Thompson, Health and Human Services secretary, and visited with members of the Texas congressional delegation.
Asked what the meeting with Mr. Bush accomplished, Mr. Ratliff said, "a friendly handshake and an assurance that our issues would be looked at."
The president was "very receptive," Mr. Laney said.
Medicaid spending problems are not unique to Texas. At least 21 states blamed Medicaid spending for their inability to stay within their budgets, according to a February survey by the National Conference of State Legislatures.
Medicaid, established by Congress in 1965, is a federal-state program that provides medical care to low-income children, pregnant women and senior citizens, as well as the blind and disabled.
The federal government, on average, pays 57 percent; states assume the rest.
The Texas lawmakers presented several requests Thursday:
• Increase funding for children enrolled in Medicaid. The federal government pays 70 percent of the medical costs for kids enrolled in the Children's Health Insurance Program, which covers children in poor families that are not eligible for Medicaid. The federal match for Medicaid, by comparison, is only 60 percent for Texas.
• Allow the state to limit the prescription drugs covered by Medicaid and automatically substitute low-cost generic drugs for comparable brand-name drugs.
• Reauthorize a grant program for poor and fast-growing states that was created when Congress approved welfare reform five years ago.
• Restore federal Medicaid funds for legal immigrants and provide additional money for states along the U.S.-Mexico border, which have a higher prevalence of poverty.
The lawmakers said Texas has been punished because the federal share of Medicaid costs depends on each state's overall economic status. Even though the border areas of Texas remain poor, the federal contribution has dropped from 64 to 60 percent because some regions performed well in the economic boom.
"You're talking about billions of dollars," Mr. Junell said. "Just a small percentage makes a huge difference."
The administration will take the requests under advisement and requested proposals in writing. "Generally, the secretary supports increased state flexibility under the Medicaid program," Thompson spokesman Tony Jewell said.
Staff writer Nancy San Martin in Austin contributed to this report.
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