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Nelson: Now the Real Work Starts on Medicaid

With 235 possible budget cuts, Finance Subcommittee begins decision-making
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“Now the real work starts.”

That’s how state Sen. Jane Nelson, R-Flower Mound, concluded a hearing this afternoon of the Senate Finance subcommittee on Medicaid.

The committee members spent the past week hearing testimony from all the Texas health and human service agencies that deal with Medicaid. The agencies presented a total of 235 possible budget cuts—or as Nelson euphemistically called them, “cost-containment proposals”—for Medicaid, everything from reduced payments to hospitals and home health workers to closing a state supported living center for the mentally disabled.

The committee is tasked with recommending to the full Senate Finance Committee how to cut $9 billion from the Medicaid budget. That’s all part of trying to close the $27 billion budget gap.

It’s clear that Nelson’s subcommittee can’t endorse all 235 proposals. As Sen. Bob Deuell, R-Greenville, put it, “Some of these are life-saving [programs]. Literally people will die if we don’t have them.” Other programs simply improve people’s quality of life.

Now that the committee has finished taking testimony, it will begin deciding which parts of Medicaid should be cut. It won’t be easy. “We’ve got our work cut out for us,” Nelson said. There will certainly be painful cuts. Nelson and Co. will begin making those decisions when they reconvene on Monday at 10 a.m.

Dave Mann has been with the Observer since 2003. Before that, he worked as a reporter in Fort Worth and Washington, D.C. He was born and raised in Philadelphia. He thinks border collies are the world’s greatest dogs, and believes in the nourishing powers of pickup basketball.