In early 2018, The Dallas Morning News published a series of stories looking into the privatization of Texas’ Medicaid program, and the impact on the sickest and poorest Texans. Some of them were denied care, even as private companies profited. Now, the Texas Legislature seems poised to address the issue, with bills that have bipartisan support.
David McSwane worked on this series, and says some of the companies to whom the state outsourced care for sick, disabled and poor Texans have been systematically skimping on the care they’re being paid to provide.
“These patients weren’t getting a lot of important, life-sustaining treatments that taxpayers had already paid for,” McSwane says.
The series contains a number of stories about specific patients seeking care, and the consequences they faced because of decisions made by private care providers.
An omnibus bill by Republican Rep. Sarah Davis would address the big picture of privatized Medicaid care. It would completely revamp the appeals process that McSwane says has been effective in getting private companies to revisit care decisions. Davis’ bill would transfer appeals to a third-party entity that would decide cases on the basis of medical need.
“Currently, it’s state employees who aren’t clinical staff, aren’t lawyers, making decisions,” McSwane says.
Davis’ bill has attracted support from a broad range of lawmakers, McSwane says, including Democrats and members of the far-right Freedom Caucus. In the Senate, two influential Republicans on the Health and Human Services Committee are also supportive.
Written by Shelly Brisbin.