AUSTIN, Texas (AP) -- Texas will use "all the money that there is available to spend" in the state budget just paying the health care costs of the growing number of poor, disabled and elderly unless dramatic changes are made to the Medicaid system, the chairman of the Senate Finance Committee said Wednesday.
Tommy Williams, R-The Woodlands, called on fellow Texas lawmakers and state agency chiefs to prepare themselves to make tough choices but offered no details on how he would change Medicaid, the joint state-federal health program for 3.6 million Texans. More than 2.7 million children, 531,000 disabled and 244,000 elderly rely on Medicaid.
State budget analysts testified that the draft Health and Human Services budget calls for a 3 percent increase in state spending in the 2014-2015 budget cycle but acknowledged that Republican leaders asked them not to factor expected growth in Medicaid caseload or medical inflation into their budget forecast.
The Republican-controlled Legislature in 2011 failed to fund Medicaid growth, and now lawmakers must pass an emergency $3.4 billion spending bill to cover those costs. After questioning by Democratic senators, Williams explained why he didn't want the anticipated costs included in the draft budget.
"If we do that, our work is done, folks. We've spent all the money that there is available to spend," Williams said. "We're not looking to narrow the number of people we serve; I'd like to see it expanded. But we can't do it the way we've always been doing it."
Williams said he was looking to proposals introduced by Sen. Jane Nelson, R-Flower Mound, to reduce costs and fight fraud, waste and abuse. Nelson asked a budget analyst how much money similar cost-containment measures from 2011 had saved, and the board reported savings of $1.8 billion, though the target had been $2.9 billion.
The Republican leadership in Texas has rejected any proposal that would raise state revenues, and Gov. Rick Perry on Tuesday called for a tax cut. Democrats and advocates for the poor, though, complain that the cap Republicans have placed on state spending will result in a cut in services to people who desperately need them.
Williams echoed many Republicans when he complained about the 14 percent growth in the health and human services budget over the past 10 years. He said for the first time the health and human services budget is roughly equal to education, historically the largest portion of state spending. But Williams reiterated that he doesn't want to cut services to those who truly cannot care for themselves.
"This is the heart of the budget; this is what decides how we look to the rest of the world because I think it says something about who we are in how we serve these people," he said. "But it's also about how we are going to deal with the other important parts of the budget."
Democrats complain that Republicans have set up a false choice between funding education and caring for children and the disabled. They have called for eliminating tax loopholes and using the Rainy Day Fund to pay for the state's needs.