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LEGISLATIVE
INTRODUCTION

Restoring Cuts to Medicaid

Children’s Disability Services

By Robert Luedecke, MD

N athan and Ethan are 2½ year-old twins. At 1½ years therapists of chil-

dren with disabilities.
Nathan began banging his head against walls and not
acknowledging the presence of his parents. His pedia-
Joe Straus is no
trician started Nathan on a very intensive treatment program for While it is true that
moderately severe autism and he is markedly improved. How would longer Speaker of
you feel if you were Nathan‘s parents and you did not have the ex- the House, it is also
tremely good health insurance necessary to help him have a more true that every Tea
normal life? Many Texas parents are in exactly that situation. Party member and
In 2015 the Texas Legislature cut $350 million from the Medicaid every Freedom Cau-
program to provide speech, occupational, and physical therapy for cus member voted in
children with disabilities. After these cuts, some therapy programs favor of this even in
closed and many cut back on the frequency of services. Especially the face of an im-
in rural areas, parents said they were not able to find therapists that pending election.
could work at the greatly reduced pay. They voted in favor
In the 2017 Legislative special session, Republican Rep. Sarah of this because they
(L to R) Nathan, Robert, Ethan
Davis said, “We made the wrong decision in the 84th legislative ses- knew it was the right
sion, and now we have the opportunity to correct that.” Concerning thing to do. They voted in favor of this despite the fact that future
a study that prompted the cuts, she said, “This was simply not a opponents might point to this vote as showing they are not conser-
valid or complete study. By restoring the [Medicaid reimbursement] vative enough.
rates today, we’re doing the right thing for Texas children while re- With the courage shown by everyone in the Texas House to stand
maining fiscally conservative.” up for restoring the cuts to Medicaid children’s disability services, will
The Texas House we have the courage to remind Gov. Abbott and Lt. Gov. Patrick this
voted unanimously to re- Depriving children of is unfinished business that can’t be forgotten? Will we follow the lead
store the cuts to Medi- needed medical care of some of the most conservative members of the Texas House in
caid children’s disability is not ‘conservative’ saying that depriving children of needed medical care is not “conser-
services. Several lawmak- and has no place in vative” and has no place in Texas politics? Will we ask our elected of-
ers including House Texas politics. ficials to find the money to do the right thing? Would it help us speak
Speaker Joe Straus and up for restoring cuts to Medicaid children’s disability services to think
Republican Rep. Matt Krause of the conservative House Freedom about how we would feel if it was our child?
Caucus urged Gov. Gregg Abbott to add the issue to the special
session agenda. The legislation died when Lt. Gov. Dan Patrick and References:
Gov. Abbott refused to consider restoring the cuts. https://www.texastribune.org/2017/08/03/House-gives-early-
For autism and many other disabilities, the younger you start ap- ok-reversing-cuts-disabled-children/
propriate treatment, the better are the results. To delay treatment or https://www.mysanantonio.com/opinion/commentary/arti-
provide less intense treatment than needed can result in more severe cle/Medicaid-cuts-devastating-Texas-families-11278498.php
disability for the rest of that child’s life. Disability advocates have https://www.texastribune.org/2018/11/07/texas-house-speaker-
pointed out that the right treatment at the right time can decrease joe-straus-midterm-election-results/
the likelihood the child will later need expensive special education.
Every member of the Texas House voted in favor of restoring Robert Luedecke, MD, is an anesthesiologist in private practice in San
cuts made to the Medicaid pay of speech, occupational, and physical Antonio.

20 San Antonio Medicine • February 2019