State officials looking for ways to cut the skyrocketing costs of providing health care for Texas convicts are now looking to an unlikely source: the federal health care law signed last year by President Barack Obama.
Under a provision of the law, virtually all state prisoners could be eligible for Medicaid coverage of their hospital stays beginning in 2014 — and the federal government would pick up the tab, officials said Friday. ...
In the past year, hospital costs for the state's prison convicts tallied more than $112.5 million — a 15 percent jump over the previous year. Officials say the state could face a $100 million shortfall for prison health care in the next two years.Under Medicaid, the feds pay 60% of costs in Texas, though experts estimate that could decline to 50% over the next 6-8 years. With the feds paying 60%, that would reduce the biennial cost of prisoner hospital care in the state budget by $135 million; at 50%, it would still shift $112.5 million to the feds, based on the current budget. That would be more than enough to make up for nine-figure cuts in prisoner healthcare enacted in the latest Texas budget, though the "Obamacare" provisions won't take effect until the next biennium.
I'm no attorney and can't say for sure, but it appears to me these provisions of Obamacare wouldn't be affected by federal litigation aimed at nixing the "individual mandate" for buying health insurance. Instead, it's a function of the portion of the law - almost certainly severable from the individual mandate - that expanded Medicaid coverage for low-income people, including younger men who make up most of the prison population and are almost by definition indigent while they're locked up. The 11th Circuit Court of Appeals that most prominently ruled against the individual mandate earlier this year did not claim that striking that provision would shut down the rest of the law. So barring something completely unforeseen - like an actual, Congressional repeal of the relevant provision in 2013 - Texas will soon have the option to sign up prisoners for Medicaid to pay for their hospital coverage. Given how much money they'd leave on the table if they chose not to do so, Grits doesn't see eschewing federal money for prisoner healthcare in 2014 as a realistic option.
RELATED: Obamacare provision a boon to budget writers on state prison health costs but complicates UTMB negotiation
Sounds like more of a question of "whose ox gets gored?" Since no governmental entity--state, federal, or local--is exactly awash in cash, this seems like more of a cost-shifting than problem solving.
ReplyDeleteToo many people locked up.
If you have an incarcerated loved one and you voted GOP, then you will have to foot the bill for medical care. We wouldn't want you to be a hypocrite, now would we?
ReplyDeleteYes, I am always amazed by the twisted thoughts some people possess in the GOP. Sorry, but you can't you cake and eat it too.
Send that tainted money back to Washington. You do you part and pay for medical care, worms!
Grits,
ReplyDeleteOne question I would ask, they comment that that hospital care totaled something over $122m. Does this include day patient care that would remain ineligible for medicaid coverage?
I could see that transporting prisoners is enough of a hassle that a higher percentage of them might be treated on an in-patient basis (the distinction being the 24 hour clock that has been mentioned in other posts, anything less than 24 hours is out-patient to US hospitals) than would be the norm on the outside, but still without knowing whether this is actually the case I am left wondering if the change would actually make that much of a difference. Of course it is also likely that in-patient care is also significantly more expensive on average, so even if it accounts for a small percent of the patient load it may still gobble up a large piece of the budget pie.
Don't know the definitive answer to that, Soronel, or where that number came from, but since they have to transport them to Galveston for hospital care, my guess is most are inpatient.
ReplyDeleteMore "crack" from the federal government to enhance the level of addiction to Uncle Sam. Isn't socialism just grand!
ReplyDelete4:31, in what fantasy land do you imagine the free market will pay for prisoners' healthcare?
ReplyDeleteGrits, why do people in prison get better healthcare than I do? Pretty soon the lower classes will be enticed to break the law seeing the room board and care as a reward for criminal activity.
ReplyDelete6:42, then you should vigorously advocate incarcerating fewer people, in order to placate your sense of fairness. If you want to keep so many folks locked up, though, the US Supreme Court says they must have access to healthcare.
ReplyDeleteI think most people just advocate incarcerating those who need to be incarcerated--both violent criminals and those who consistently demonstrate a willingness to violate the law. Liberals can hide behind the Supreme Court all the want. Supreme Court precedent can change. Criminals forfeit lots of their rights. In a society where many innocent children are deprived of basic health care, how can we justify providing anything more than rudimentary health care to criminals? And no, it's not society's fault they're incarcerated. It's their own fault. This may sound harsh and uncompassionate, but we've just about reached a turning point in this country. We will always have to remove the criminal element from society. But tax resources are limited. If it comes down to a choice between healthcare for criminals and the truly deserving and needy, then that's a no brainer. Incidentally, do you know how many times the Constitution has been amended? It could happen again.
ReplyDelete7:35, you get to work on that constitutional amendment, but in the meantime the rest of us must live in reality, where Supreme Court opinions still apply and incarcerating people still costs money. As long as that's the case, incarcerating fewer people - particularly the older, sicker ones - is the quickest way to reducing prisoner healthcare costs.
ReplyDelete@ Anon 7.35 - the reason so many children are denied basic health care in America is because America does not have a universal health care system, because most Americans are so selfish that they are unwilling to contribute to one.
ReplyDelete@Anon 6.42 - how exactly does being carted around the state with a groin hernia, having the operation cancelled twice after being starved for 2 days each time, and then being made to walk down to a holding cell and being put back on the chain bus in shackles for another indeterminate journey just 20 minutes after coming out of the anaesthetic constitute better health care that you would get in the free world? Or do you just mean "better" because the inmate (in your eyes) does not pay for it with cash?
I do find it very interesting that some of the very people who are demanding the repeal of "Obamacare" are the same people hoping that it'll cost the state less. So, if the TEA Party and GOP are successful and the healthcare act goes away, I'm curious as to TDCJ's plan for this. Maybe grits and a protein patty will be served twice a day 6 days a week? Oy vey.
ReplyDelete