The Budget Puzzle–Part Three

The 2014-15 consolidated HHS proposal to provide CHIP and Medicaid-supported health care, Early Childhood Intervention programs, foster care/child protective services, state hospitals, and various public health and nutrition services includes the following:

  • a $1.4 billion General Revenue baseline increase (from $27.7 billion in 2012-13, after paying the Medicaid I.O.U., to $29.1 billion in 2014-15);
  • $1.6 billion General Revenue in current services “exceptional items”; and,
  • $259 million more in General Revenue for Aging and Disability Services community care programs and $81 million for State Health Services waiting lists, needed to keep existing waiting lists from getting even longer – a long-standing legislative priority.

Combined, this $3.3 billion in General Revenue would draw down an additional $4.7 billion in federal money, mostly through a Medicaid match that will provide $1.42 in federal health care dollars for every state dollar Texas spends. More importantly, it would preserve the existing safety net for the almost 5 million Texans, by covering what’s called “current services” growth.  (More on that at the end of this post, for those of you who aren’t familiar with that term.)
In addition to covering current services, the 2013 Legislature should also seize the opportunity to expand Medicaid to low-income adults and significantly improve access to health care. Health care services would be 100% federally funded in the 2014-15 budget (also in 2016) for these Texans, leaving the state to cover only a small share of the expansion costs.  The state estimates that $8 billion in federal money would flow into the state’s economy if the legislature approved $310 million in General Revenue for this expansion – a $26 to $1 match.
Finally, $400 million in General Revenue would help make up for the anticipated loss of federal mental health, nutrition, and other social service dollars, as well as undo the 2011 cuts to family planning services. Restoring and expanding access to these services not only saves the state money; like the adult Medicaid expansion, rational state budget choices would help city and county budgets as well.
EXPLAINER: “Current services” estimates tell budget-writers what’s needed to serve a higher number of clients mandated by existing law, as well as higher costs per client – usually, health care cost increases.  Health and human services is the one area of the Texas state budget for which “current services” estimates are still available, after the practice was discontinued for other state services in the early 1990s. These “current services” estimates are part of the consolidated budget prepared every two years by the five HHS agencies, along with the individual budget requests that all state agencies prepare.
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