Posted in the San Antonio paper: http://www.mysanantonio.com/news/pol...ors-972588.php

Nursing home advocates are alarmed over a Texas House proposed budget recently put forth in Austin that includes a 34 percent cut in Medicaid provider rates for fiscal year 2012-2013 — three times higher than expected.

“If this budget remains as it is proposed, nursing facilities will close,” said Alvin A. Loewenberg, president and CEO of Morningside Ministries. He said those in the nursing home industry believed the cut would be 10 percent.

“Medicaid residents will have no place to go,” he said. “I am embarrassed that the state of Texas has so little concern for older folks, their families, and those who care for them in nursing homes, many of whom are working poor.”

Most nursing facilities are already losing money at the current rate, he added.

The cuts also apply to physicians and hospitals that participate in Medicaid.

A staff member in the office of Speaker Joe Straus said the larger rate reduction is the result of federal stimulus funds that won't be replaced in the next biennium.

Allison Lowery, media relations manager for the Texas Department of Aging and Disability Services, said the agency's budget team is still analyzing the numbers.

“This is only the starting point in what's going to be a long, complex process,” she said.

Medicaid provider rates were cut by 1 percent in September. Another 2 percent cut will happen in February.

George Linial, president of the Texas Association of Homes and Services for the Aging, said nonprofit nursing homes that largely rely on Medicaid are going to be especially hard-hit by the higher cuts.

“Organizations that have provided benevolent care for almost 100 years in Texas are going to close their doors to caring for our most frail elderly in the state,” he said. “This is a travesty for the people of Texas. These cuts will be the death blow to Medicaid providers in Texas.”

David Thomason, senior vice president of public policy for TASA, said the current Medicaid reimbursement rate is less than $125 per day. The cut will reduce it to about $80 a day.

Thomason said lawmakers' staff members have assured him that, even with the lack of federal money, the gap won't be closed “on the backs of providers and elderly.”

“But that's exactly what these cuts do,” he said. “They close the gap on the backs of seniors and those who care for them.”

Barbara Dulem, who runs the 60-year-old Sarah Roberts French Home, a nonprofit, said if the cut stands, she'll be force to close her doors.

“That's my only income, Medicaid,” she said. “I can barely function as it is with the other cuts they've already made. We're making drastic changes as we speak — cutting back staff, trimming expenses anyplace we can. If this (34 percent reduction) doesn't do us in, then health care reform in 2014 will.”

Thank Obamacare for the extremes?