State Cut Now a Medical Emergency

A combination of poorly informed government decisions and bureaucratic bungling is creating a medical emergency for Texas’ thousands of dual-eligible Texans and the physicians who care for them. "Dual-eligibles" are people old enough to qualify for Medicare as their health insurer, and poor enough to qualify for Medicaid assistance. Hundreds of thousands of these seniors live across Texas. But budget cuts and bureaucratic bungling are threatening their care — and more.

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Javier Saenz, MD, is a Rio Grande Valley family medicine physician who cares for many of these patients. They make up about half of his practice. Since January he’s treated these patients as always, but has received no Medicare payments and very little in payments from Texas through Medicaid. As a result he is exhausting personal savings and turning to bank loans to make payroll and keep his medical practice open to serve his patients. He doesn't know how long he can hold out.

“If all I see are my most needy patients I can’t stay in business,” Dr. Saenz told the Texas Medical Association. “If I can’t stay in business then I can’t help anybody.”

Dr. Saenz is not alone. Physicians who care for dual-eligible patients in poor communities from rural Texas to inner cities are caught in this vise.

Victor Hugo Gonzalez, MD, told the Rio Grande Guardian that the high density of dual-eligible patients in the Valley (he estimates it’s around 60 percent of the total patient population for family physicians), combined with reimbursement cuts for these patients, is leading many doctors to leave or retire, threatening the medical infrastructure for the Rio Grande Valley.

UPDATE: Texas' dual-eligible emergency makes headlines

• State Cuts Squeezing the Elderly Poor and Their Doctors - The New York Times, in partnership with The Texas Tribune
• VIDEO: TMA visits Valley to do a story on physician funding crisis - Rio Grande Guardian