Today, Senate Finance began hearing testimony from Health and Human Services (HHS) agencies, which administer most of the state’s social services programs, such as health care for low-income Texans (4.3 million in 2013) enrolled in Medicaid and CHIP; child and adult protective services; the Supplemental Nutrition Assistance Program, formerly Food Stamps; and community and nursing-home long-term care, to name just a few. The share of state spending in 2014-15 going to HHS would stay about the same, at 37% of the total budget. Almost three-fifths of the money for HHS agencies would come from federal dollars.
The Health and Human Services Commission receives the lion’s share of HHS dollars, and is also the most underfunded HHS agency in SB 1 as introduced. Medicaid caseloads are expected to reach 4.515 million by fiscal 2015, 11% higher than the 4.058 million included in SB 1 funding levels. Even worse, health care cost increases for Medicaid and CHIP are for the most part left out of the Senate’s budget draft. Paying for both current services enrollment and cost growth for Medicaid and CHIP would require $2.8 billion more in General Revenue, which would draw down another $3.4 billion in federal dollars.
After hearing from all HHS state agency officials, the Senators will take public testimony. If past sessions are any indication, much of it will be in support of an HHSC “exceptional item” proposing a 50-cent hourly wage increase for community care attendants. This would cost $177 million in GR in 2014-15, draw down $252 million in federal dollars, and most important of all, help reduce turnover and improve care received by community care clients.