CMS official expresses concerns with timeline, scope of Texas Medicaid overhaul plan

In an Aug. 7 letter to Texas Health and Human Services Executive Commissioner Albert Hawkins, CMS official Dianne Heffron questioned whether the state's plan to overhaul Medicaid by providing subsidized health coverage to 2.1 million uninsured residents would move quickly enough and be broad enough to justify relaxing federal rules, the Dallas Morning News reports. Heffron wrote, "It appears that significant, comprehensive reform would not begin until September 2010."

In April, Hawkins suggested that the plan could use federal matching funds from safety-net hospitals to purchase coverage in the plan's third year for the uninsured residents (Garrett, Dallas Morning News, 8/22). Hawkins also said that the plan to provide health coverage to about 482,000 uninsured parents whose children are enrolled in Medicaid or SCHIP will not begin this fall as planned. The program, which is mandated by the state Legislature, is intended to reduce the number of uninsured residents with incomes too high to qualify for Medicaid but below 200% of the federal poverty level. Commission spokesperson Stephanie Goodman also said the uninsured probably would not have access to the program until 2010 or 2011 (Kaiser Daily Health Policy Report, 4/9).

On Thursday, some health care advocates said the letter's tone suggested that state officials would not be able to get federal approval for the plan before the end of President Bush's term in office. However, Goodman said Heffron's letter will not affect the progress of the plan. "It's good that the negotiation process is starting," she said (Dallas Morning News, 8/22).