The Weekly Insight: February 25

Texas Insight Staff

February 25, 2019

Texas Insight’s Recent Reports

Health and Human Services Commission: 86^th Legislative Session Update. The HHSC Executive Council gathered to hear 86^th Legislative Session updates concerning the Health and Human Services Commission, the Department of Family and Protective Services, and the Department of State Health Services. Additionally, they received updates on the flu and measles and heard proposed rules and advisory committee updates. Read TXI’s coverage of the meeting here.

Medicaid Block Grants in Texas. The Trump administration and Texas leadership continue to offer a block grant model as a more “flexible” form of the Medicaid program than the traditional model, in place since the program’s 1965 inception as part of Lyndon Johnson’s Great Society. Texas advocates of replacing traditional Medicaid with block grants are urging Texas leadership to pass a contingency Medicaid block grant act that will go into effect when a federal plan to block grant the program is in place and to lobby the Texas Congressional delegation to make block grants a priority. This posting explores block grant design and the impact of transforming Texas Medicaid to a block grant. Follow this link for the full report.

Intellectual and Developmental Disability System Redesign in Texas. The IDD System Redesign Advisory Committee gathered to hear an overview of the Intellectual and Developmental Disabilities (IDD) Carve-In Evaluation Report by Deloitte. Key points included:

Deloitte conducted the cost-effectiveness aspect of the overall evaluation, looking specifically at managed Long-Term Services and Supports for people with IDD.
Four different scenarios were reviewed in order to come up with a range of estimates. Assumptions varied based on which services are carved in, how many people choose to enroll in managed care, the assumed utilization impacts of managed care, and administrative cost.
All scenarios resulted in some savings for utilization management or efficiency, but when you factor in the administrative cost, all of the scenarios resulted in a net cost.
Premium taxes: there’s a difference in the potential cost to the State of Texas vs HHSC, based on the way premium taxes are factored in:
- State: Net cost ranged from $3.7 to $16.6 million/GR, 2021-2022
- HHSC: Net cost ranged from $12.1 to $34.6 million/GR, 2021-2022

Follow this link to read the full report.

Medicaid. The Medical Care Advisory Committee gathered to hear updates on Medicaid and CHIP activities, as well as proposed rules involving Medicaid policy or affecting Medicaid-funded programs. Click here to read the full report.