Priority one for state lawmakers meeting in Austin next week is to plug a $25 billion budget shortfall. Just how big is that? Well, if you shut down all the prisons, laid off every state trooper, eliminated every service except public education, higher education and health care, you still wouldn't cut $25 billion.
Governor Rick Perry and others have suggested Texas drop out of Medicaid, the federal-state health program for low income children, elderly and the disabled. It's Texas's fastest growing expense.
BJ Austin reports that even without future cuts, disabled Texans who qualify for Medicaid services can't get them.
Ramon Williams of Dallas is 30 years old, and spends his days in a wheelchair. He cannot speak or walk. He has cerebral palsy.
For the past nine years, Ramon has been on the state's waiting list for Medicaid Home and Community Services. Those services include in-home help. Doris Williams wants in-home help that would assist with Ramon's feeding, bathing, changing his diaper, interpreting his needs. She has been doing all of that by herself for 30 years -- except when Ramon is in "day-hab", a special daycare for the disabled that operates weekdays.
Williams: The school, the day-hab I have him in now, they've informed me this month that his last day of going to school will be Jan 31st because they're only going to do HCS, which is Home Community Service, which is the list I've been on for 9 years. So now, I've got the task of trying to figure out how I'm going to take care of him, go to work, or stay and home and sink further in poverty.
Williams worries the location of a new day-hab may increase her commute and make it impossible to keep her job and take care of Ramon. She says Medicaid Home and Community Services could help with that. But, Williams says the prospect of getting those services has gone from bad to worse. Right now, there are 41 thousand Texans on the waiting list. In Dallas County alone, five to eight people are added to that list each week. And this year, when the state cut the budget, it reduced the number of people served. And now, there's more uncertainty with the prospect of Texas opting out of Medicaid all together.
Williams: I don't know what our lifestyle is going to be now. I lay awake at night.
Metrocare Services has been paying the day care tuition for Ramon. And officials are trying to find a new place for him. But Metrocare is expecting state funding cuts of up to 18%, and is making cuts of its own. Executive Director Dr. James Baker says the budget cuts have a serious impact on families.
Baker: That's a very painful situation to tell somebody the services they were expecting to get aren't going to be coming their way.
Dr. Baker says opting OUT of Medicaid would have widespread consequences.
Baker: It's a shift in the cost burden from the state to local governments and local hospitals. It wouldn't be just Parkland. It would be private hospitals in the community as well. It's a shift from being paid for by state tax dollars to being paid by your local taxes and thru your insurance. If people are going to emergency rooms for care that don't have any insurance, the way that cost gets paid is through insurance premiums of everybody paying at their jobs.
Ramon's mother, Doris has a message for lawmakers.
Williams: Individuals with disabilities should not be the first ones on the chopping block.