Over Democratic objections and against Texas House Speaker Joe Straus’ wishes, the Legislature this year won’t undo severe cuts adopted in 2015 to a program that serves low-income children with disabilities.
The House on Friday voted 115-21 to go along with a Senate budget plan that declines to alter the dramatic reductions — totaling about $350 million in state and federal money last year and this year — in the rates paid by Medicaid to therapists who primarily serve children with conditions like Down syndrome, shaken baby syndrome and hydrocephaly. Advocates say the cuts are making the program untenable for therapists and will lead to fewer children being served.
Friday’s vote sends House Bill 2, which is known as the supplemental budget and is intended to plug holes in the state’s current two-year spending plan, to Gov. Greg Abbott. The $1 billion measure primarily pays down a shortfall in the state’s contribution to Medicaid.
Although they have declined to aid the therapy program this year, lawmakers are poised on Saturday to restore 25 percent of what was cut in 2015 for 2018 and 2019, when they take up the next state budget, Senate Bill 1.
Rep. Donna Howard, D-Austin, voted against House Bill 1, saying she and other Democrats needed to take a stand for a program that helps children with skills “that are critically important to the development of these children.”
“We’re not just talking about learning how to say R. We’re talking about learning how to swallow,” she said.
Before the legislative session, Straus called the therapy cuts a mistake and said they were driven by the Senate. But on Friday, House Appropriations Chairman John Zerwas, the lower chamber’s chief budget writer, said he was unable to convince the Senate to budge.
“I just don’t have any ammunition left. It would be truly a futile exercise to go to conference,” Zerwas said.
Last legislative session, the Legislature approved $350 million in cuts to Medicaid reimbursement rates for therapy providers, primarily those serving about 60,000 children with disabilities statewide. The Senate proposed the measure, justifying it through a commissioned study that lawmakers said showed Texas was reimbursing therapists at higher rates than other states and commercial insurance programs.
Arguing that the cuts would force physical, occupational and speech therapists to close their doors, therapy providers tried stopping the cuts through a lawsuit but lost. So far, at least three home therapy provider groups in the Houston, Panhandle and Wichita Falls areas have stopped some or all services for Medicaid patients, according to the Texas Association for Home Care & Hospice.
“This has always been about the children with disabilities who need access to this vital therapy care and the moms and dads who fight so hard for their kids,” Rachel Hammon, executive director of the home care association, said on Friday. “We can only hope that senators go home and take the time discover the real and frightening access-to-care crisis happening to their constituents and families in all corners of the state.”
The Texas Health and Human Services Commission is proposing further cuts effective July 1 to the already reduced rates for Medicaid therapy providers.
Both houses of the Texas Legislature on Saturday are expected to vote on a $216.8 billion budget that makes significant cuts to many state agencies, does little to improve the widely criticized school finance system and maintains the state’s $800 million commitment to border security spending.
The budget, proposed by a committee of House and Senate negotiators, slightly increases spending levels from the current two-year budget. But after factoring in inflation and population growth, it translates into a roughly 8 percent overall cut.