Viewpoints: Texas needs to help — not pick on — children with disabilities

Picking on the most vulnerable is not the Texas way. Yet, it is exactly what state lawmakers do each time they take aim at programs that serve children with disabilities. It’s no surprise then that in its quest to change how it handles Medicaid, Texas has hurt more than helped hundreds of children with disabilities.

The list of hurt caused by cuts and the privatization of Medicaid is long. Families report less access to much-needed medical services, such as life-altering therapies and critical prescription drugs for children, the American-Statesman’s Julie Chang reported. Less timely access to services has created life-or-death situations for some children and regressed hard-fought progress for others.

This can’t continue. The Legislature needs to help Texas find its way back to standing up for these children, not knocking them down.

SPECIAL REPORT: How Texas Medicaid is failing children with disabilities.

Lawmakers can start by reinstating funds for therapy services and to early intervention programs that help improve the quality of life for children with disabilities. State leaders should also demand transparency from organizations managing Medicaid programs and set aside enough resources to properly supervise those contracts.

For years now, a Republican-dominated Legislature has cut programs that serve the state’s poor and vulnerable. That includes the Legislature’s steady course to the privatization of Medicaid, a state and federally funded program that has successfully served children with disabilities from families of all economic statuses. Cuts to such programs, lawmakers say, save us money. Meanwhile, the state’s most vulnerable continue to pay the price.

Consider that in 2011, a tough budget year for the state, lawmakers cut costs by limiting eligibility for Early Childhood Intervention services to children with the severest disabilities. Such services for children up to 3 years old help kids with developmental delays and disabilities prepare for kindergarten while saving the state money on costly special education services down the road.

Since the state’s narrower eligibility requirement, enrollment for Early Childhood Intervention services has dropped 14 percent statewide to 59,000. Funding for services has declined 11 percent to $142 million in 2017, Chang reported.

In 2015, the Texas Legislature lowered Medicaid reimbursement rates to physical, occupational and speech therapists that serve children with disabilities by $350 million. Lawmakers restored a quarter of the cuts this year, but health commission officials made more reductions in September.

FOLLOW US ON TWITTER: Viewpoints delivers the latest perspectives on current events.

Without proper therapy, progress a child has achieved can stall or reverse. Legislators should reinstate those funds.

Then last year, Texas turned over Medicaid services for children with disabilities to private companies and hospitals, called managed care organizations.

The move was part of a multiyear transition into the state-created STAR Kids managed care program approved by the Legislature in 2013. Now, instead of handling the medical services for 164,000 children with disabilities, Texas pays managed care organizations by the patient, not the services delivered. The program is expected to save the state hundreds of millions of dollars.

As many suspected, the move has been anything but smooth.

Between February and May, 12 percent of children with the severest disabilities were denied Medicaid services, triple the overall rate of 2016, according to the Texas Health and Human Services Commission.

Under STAR Kids, surgeries previously approved are now being denied; access to critical medication and medical supplies has become difficult; patients are waiting longer periods between appointments and receiving less time with specialists and therapists; and children are being denied coverage and services without explanations.

It’s not surprising. Less services mean more profits for managed care organizations.

Texas’ least fine hour came when the Legislature chose to continue with a managed care model knowing it would be riddled with problems. State leaders know that health insurers cut corners and can inflate diagnoses to maximize profits. Still, they proceeded.


As expected, grievances have been plentiful. Since last November, more than 2,500 complaints from providers and families have been lodged against STAR Kids, according to the health commission.

LIKE US ON FACEBOOK: Our Lone Star Politics page brings Texas news to your Facebook feed.

The commission is addressing the increase in denials by analyzing whether the STAR Kids assessment tool used by managed care organizations to determine services is accurate. The commission should mandate that no child with a disability be denied service or coverage until all necessary fixes to the assessment tool are complete.

Legislators must demand transparency and appoint resources to ensure that, in this case, managed care organizations deliver on contract expectations.

Texas once placed importance on investments that help our most vulnerable. We need to get back to those values.

Reader Comments ...

Next Up in Opinion

Letters to the editor: Nov. 21, 2017
Letters to the editor: Nov. 21, 2017

On Veterans Day, entering the grocery store I noticed “The Star-Spangled Banner” playing. Tables were set with finger sandwiches, chips, dips, and cake was being distributed by store personnel dressed in patriotic gear. As I shopped, the anthem kept playing on a loop. After the fourth repetition, I explained to a store employee when the...
Letters to the editor: Nov. 20, 2017

Re: Nov. 13 commentary, “Wear: MetroRail station late and costlier? Yes and no. Maybe.” Apparently, our local transit planners have never heard of “connectivity.” Pieces of our transit system don’t connect. The Capital Metro downtown rail station is blocks from both the Megabus terminal and the north-south 801 and 803...
Commentary: How Texans suffer without office of minority health
Commentary: How Texans suffer without office of minority health

During the past legislative session, Texas lawmakers canceled funding for the Office of Minority Health Statistics and Engagement (OMHSE) beyond Sept. 1, 2018. In effect, this means Texas could soon become the first state in the nation without an office of minority health. This is a bad decision by our lawmakers because Texas institutions continue...
Commentary: How NAFTA, immigration influence Texas’ economic future
Commentary: How NAFTA, immigration influence Texas’ economic future

Future challenges faced by the Texas economy with trade, immigration and border governance policies were the focus of a recent symposium convened by UT Austin’s LBJ School of Public Affairs and its Texas 2030 Project. Some eye-opening facts emerged. Today’s Texas economy depends heavily on international trade and is built around technology...
Herman: Uncertain times in a media industry with an uncertain future
Herman: Uncertain times in a media industry with an uncertain future

I recently manned a table at career day at North Austin’s Padron Elementary School. It didn’t take me long to confront, in my head, the stark reality that I was talking to kids about a career that (a) might not look like it does now or (b) won’t exist when they age into the labor force. I work at a newspaper, which these days means...
More Stories