Shaking Down Public Hospitals
March 30th, 2007 at 4:18 pm
We’ve always known that Texas is a low-spending state, but now that lawmakers are trying to steal money from local public hospitals, well, it’s getting a little ridiculous.
We’ve learned that the Health and Human Services Commission (HHSC) is arm-twisting county hospital districts into paying HHSC more than $150 million over three years to bankroll state operations. If this arrangement sounds a little backward — robing municipalities of their local tax dollars to finance state programs — it’s not exactly what we learned in civics class, either.
The back story is a little complicated, but here’s how we hear the deal went down. In 2005, the Legislature passed a bill that would have instituted managed care in the Medicaid program statewide. This was supposed to save a lot of money (some critics dispute the savings and say that the HMOs sold the Lege a bill of goods, but it all depends whom you talk to.) The county hospitals went apoplectic since managed care would cost them millions in federal matching funds — the reasons for that are complex, and we won’t bore you with them.
HHSC chief Albert Hawkins told the counties that he sympathized but there was nothing he could do — the savings were written into his budget and he had to cut the money from somewhere. So the county hospitals came up with a solution: They agreed to pay $58.5 million to HHSC in June 2007 so Hawkins could make his budget, and the counties wouldn’t lose matching funds from the feds.
It was supposed to be a one-time payment. Somehow, though, that one-time payment showed up as recurring state income in the Lege’s budget for 2008-2009 (see SB 1). Now, unless the budget is changed, the public hospitals are on the hook for three years of payments to the state to the tune of $150 million.
The public hospitals — such as Parkland in Dallas and Brackenridge in Austin — aren’t exactly rolling in dough: they have suffered greatly the past few years due to state budget cuts and the rising uninsured rate. The increasing number of Texans who lack health insurance flock to public emergency rooms for care — that comes out of municipal budgets.
Moreover, we have to wonder about all those legislators under the Pink Dome who profess so loudly to care about property taxes. It seems the Lege has found another way to shift the cost of state government on to local property taxpayers.
