Texas Medicaid lapse concerning for rural health providers

Published: Apr. 10, 2023 at 8:40 AM CDT
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LUBBOCK, Texas (KCBD) - An estimated 5-to-15 million could have their Medicaid insurance coverage lost this month.

As of April 1, pandemic Medicaid coverage ended, because the state of Texas did not expand coverage. This is the start of what could be trouble for rural Texas hospitals and also a time for lawmakers to brainstorm ways to re-work the system.

For people like Melanie Richburg, running the only hospital in Tahoka has always been a difficult task. But some more trouble could be ahead.

“We’re not asking just to give me more money in general. Just give me more – just pay my costs,” Richburg, the CEO of Lynn County Healthcare System, said. “Give me enough to pay the bills I need to pay to keep this place open.”

She expects about 15% of the people she serves to lose Medicaid coverage, because of this recent lapse.

“You’re going to see more emergency rooms with life-threatening situations because mammas and daddies don’t have the money to buy the asthma medicine that traditionally they had used with their Medicaid … and an emergency room is a very expensive place to receive primary care.”

Her hospital was prepared, though.

A while back, she created a position to help people find ways to pay for their treatment or to find coverage, called a patient navigator.

“Her no. 1 job is to screen any patient that comes in, that does not have insurance or the ability to pay,” Richburg said.

Still, the expectation is some folks with be unable to pay for any care at all. That is something people like Billy Philips, with Texas Tech University’s Health Sciences Center is hearing too.

“When they got on Medicaid at least I could cover my costs on rendering that care,” Philips, the executive vice president and director TTUHSC F. Marie Hall Institute for Rural and Community Health, said. “That paid something rather than nothing. Behind all this, is the necessity to make changes to that program entirely.”

And now is the time.

He says, legislators are tasked with figuring out what health care systems changes could work for Texas.

“We have a statutory duty to educate our decision makers… our job is to be sure to make sure they have the facts to make the best decision,” Philips said.

What he would like to see for rural health care is getting more people insured and not burdening them with re-enrolling in coverage annually.

But, because the focus is on rural, that is a tough ask, because the population numbers can be hard to justify major changes.

“You do have to have something, you can’t just be a community without a hospital,” Philips said.

And for people like Richburg, it also highlights the difficulties rural communities face on a regular basis.

“I truly believe people in the rural communities deserve the same quality and level of health care that you would get if you walked into a clinic up in Lubbock,” Richburg said. “Let’s worry about 90% rather than 1%. Well, if that 1% is you, it’s pretty important.”

Related Link: Pandemic Medicaid coverage is ending. Here’s what that means for people using Medicaid health benefits.

Related Link: 10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision