Commission Suggests Texas Medicaid Beneficiaries Pay Enrollment Fee As Cost-Saving Measure

The Texas Health and Human Services Commission, which oversees the state's Medicaid program, is considering charging Medicaid beneficiaries a voluntary enrollment fee and copayments on some health services as part of an effort to save at least $3 million, the San Antonio Express-News reports. Over the last month, commission members have considered various cost-sharing proposals, including a plan that calls for beneficiaries to pay $3 per non-emergency care visit received in an emergency room and $1 to $3 per brand-name medication. However, an advisory work group organized by the commission was "not enthusiastic" about the copayment proposals, calling them "administratively unworkable and unlikely" to discourage beneficiaries from seeking primary care services in emergency rooms. Instead, work group members are considering an enrollment fee of $5 to $10 per individual and $15 to $20 per family. The fees, which, if implemented, would be the first in the nation, would require federal approval and also would have to be voluntary because Medicaid is an entitlement program. Depending on collection rates, early estimates suggested the fees would raise anywhere between $133,000 and $4.4 million. However, the administrative costs of collecting the fees could eliminate any savings, according to commission officials. The commission hopes to have a cost-sharing program in place by Sept. 1 (Selby, San Antonio Express-News, 4/11).