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Editorial: Don't imperil access to vital health programs

Austin American-Statesman - 9/20/2020

The savings would have come at too great a cost.

Thankfully Texas officials recognized that and dropped plans this week to cut $15 million from state health and safety net programs. These short-sighted budget cuts would have come at the expense of our neighbors: Families with young children who have disabilities or developmental delays. Women who need birth control or cancer screenings. Texans needing help with treatment for epilepsy or hemophilia.

While the funding for those programs is no longer in jeopardy, however, the Texas Health and Human Services Commission (HHSC) still has about $130 million in suggested cuts on the table -- part of a state mandate to trim 5% in spending as the coronavirus punches holes in the state budget. Many of those cuts should worry Texans.

Cutting administrative costs, as the agency proposes, may sound innocuous enough. But documents show the HHSC is talking about reducing or delaying the hiring of 742 workers who help Texans qualify for vital health and safety net programs.

Fewer workers processing or evaluating applications could mean longer wait times for Texans trying to sign up for food stamps. Longer wait times for pregnant women trying to sign up for Medicaid to get important prenatal visits covered. Longer wait times for those trying to qualify for the Healthy Texas Women program so they can obtain affordable birth control. And possibly delays for children who rely on state health programs so they can get checkups and other basic care.

"These cuts would be a bad idea at any time, but they would be particularly harmful now as the state's worst-in-the-nation uninsured rate climbs even higher for kids and adults," said Stephanie Rubin, head of Austin-based Texans Care for Children.

HHSC also proposes saving money by reducing or delaying the hiring of 98 workers involved in overseeing nursing homes, hospitals, residential facilities for children and other facilities. Leaving dozens of these posts vacant, according to the agency's own proposal, could impact the state's "ability to conduct investigations" in a timely way and increase "the number of backlogged investigations."

HHSC also says the cuts could pile more cases onto the plates of staffers who monitor child care facilities. This is a particularly troubling step backwards, after the Legislature took bold steps last session to improve the safety and monitoring of child care centers. Those badly needed improvements came after the Statesman's Unwatched investigation found that more than 88 children had died of abuse and neglect in Texas child care sites over the previous decade, that an additional 450 children were sexually abused and that the state was often ineffective in punishing child care facilities that racked up scores of rules violations. We've seen what happens when these facilities aren't properly monitored. We must not allow that to happen again.

We recognize state officials face extraordinarily difficult decisions. The comptroller has projected a $4.6 billion shortfall for this two-year budget cycle. Sales taxes, franchise taxes and gas and oil taxes have all taken a hit as the coronavirus has hurt businesses, pummeled paychecks, curbed spending and shelved travel plans. Like the businesses and families struggling through this pandemic, Texas must live within its means.

That means setting priorities. In some parts of the state budget, that will mean cuts. But programs that protect the health and safety of Texans are too important to cut. That is true for the program dollars themselves -- which state officials have rightly decided to protect -- as well as the administrative costs of providing these programs, which HHSC now looks to squeeze.

Texas leaders have other options. The state's Rainy Day Fund exists for emergencies like this. Lawmakers can examine ways to raise revenue by closing certain tax loopholes. And, as Rep. Donna Howard, D-Austin, and others have noted, and as we have long supported, Texas could bring in roughly $10 billion a year from the federal government to better serve health care needs by expanding Medicaid.

Texas officials made an important concession this week by undoing proposed cuts to the direct funding for women's and children's health programs. But officials must do more: They must protect the administrative positions that help Texans access these and other vital programs.

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