In less than three weeks, Texas plans to implement $350 million in planned cuts to an insurance program that pays for speech, physical and occupational therapy for children with disabilities.
The cuts, set to go into effect July 15, impact state and federal dollars from Medicaid, a program that provides health coverage to people with low income or disabilities.
Children like 7-year-old Macario Chavarria III, of Dallas, could be negatively impacted. Chavarria has autism and takes part in doctor-recommended, twice-weekly speech and occupational therapy at a clinic in Oak Cliff.
“Just until a couple years ago he was still just saying one to three words,” Macario's father said. “I was thinking, ‘Well, he’s not going to be a normal little boy.’”
Chavarria Jr., a single father raising two children, said he's seen a big improvement in his son's speech and social skills since the therapy sessions at a clinic run by Easter Seals North Texas, a non-profit organization serving children and adults with disabilities and special needs.
The Chavarria family uses Medicaid to pay for therapy, as do tens of thousands of families of special needs children.
“This is a really dangerous situation that our state is getting us into,” Therapeutic and Autism Services for Easter Seals North Texas Vice President Jennifer Friesen said. “One of the things that Easter Seals is most concerned about is the long-term impact that these cuts will have.”
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Friesen said the Medicaid cuts will result in a decreased reimbursement rate for providers of therapy services, meaning clinics will not be able to cover costs.
That will result in a number of unfortunate outcomes, according to Friesen, including some clinics dropping patients who use Medicaid for their insurance.
“If these cuts go through, there is potential Macario won’t be able to access service because the reimbursement rates are so low that there won’t be very many therapy providers available to families because many of the therapy providers are not going to be able to accept Medicaid rates only on a limited, with a limited number of clients,” Friesen said.
Last week, Democrats in the Texas House reached out to the Obama administration to request some form of intervention.
In a letter addressed to the Acting Administrator for the United States Department of Health and Human Services Centers for Medicare and Medicaid Services, all 50 Democratic Texas representatives asked help ensuring that medically necessary therapy continue unimpeded.
“We urge CMS to expeditiously review the State Plan Amendment to ensure that proposed rate reductions do not restrict access to medically necessary therapy services, regardless of the setting, type of therapy, or whether the therapy service is provided in a managed care or fee for service model,” the letter notes in its concluding paragraph.
The motivation for the cuts was based in the concern by state lawmakers that the Medicaid system was wrought with fraud, and that its ever-increasing budget needed to be brought under control.
Macario Chavarria, Jr. said he is not sure what will happen if Medicaid cuts impact his son’s access to therapy. But he is concerned that this is something he even needs to worry about.
“I kind of feel upset about it, because it’s not hurting us as parents. It’s hurting the kids because that’s something that’s helping them for the future,” Chavarria, Jr. said. “Something that the need to develop so they won’t stay behind.”
