Texas medicine
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The Medicaid 1115 waiver program had lofty goals to make Medicaid work better, including accountability. But its financing mechanism favors hospitals and in some case is creating bureaucracies and funding disputes that overshadow the waiver's goals. That is drawing attention from lawmakers.
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This study projects the number of nonelderly people who could gain coverage under the Patient Protection and Affordable Care Act (PPACA) for the period from 2014 through 2020 in the 13-county Houston-Galveston area region. The major PPACA provisions aimed at expanding coverage as well as the populations targeted by those provisions are described. Projections of the impact of PPACA on coverage in the area are based on estimates of growth in the size of targeted populations in each county and the anticipated responses of those populations to the major provisions of PPACA. ⋯ This change translates into health insurance coverage for approximately 2 million additional people, from the current 4.2 million to a projected 5.9 million. The number of Medicaid enrollees could increase by an estimated 600,000 (a 79% increase), although private insurance coverage, which could increase by as much as 1 million enrollees (a 30% increase), will remain the primary source of coverage for most people. Coverage gains from PPACA will vary considerably by county, depending on the age-income-citizenship characteristics of the population, current uninsurance rates, and the rate of population growth.
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Texas physicians fear that sharp funding cuts in state family planning services and changes in a state health program for women will threaten women's access to vital preventive services. They say the situation is a crisis and urge lawmakers to restore money to programs that provide low-income women with recommended screenings and birth control.