State botched cuts in Medicaid therapy

The Texas Health and Human Services Commission argues that cutting $350 million from a therapy program for poor and disabled children won’t harm them, but it has little to back up that counterintuitive theory.

So when faced with the challenge of convincing an Austin judge of its argument this week, the commission’s lawyer chose the straightforward approach: Make fun of the therapy providers and families of disabled children who say their kids will be harmed, then simply say it won’t happen.

Eugene Clayborn, a lawyer representing the state, characterized providers and families as saying that “the sky is going to fall in.”

“There will still be access to care,” Clayborn said, according to The Texas Tribune.

His phrasing is crucial. In ordering the commission to cut $350 million from therapy rates paid under the Medicaid program, the Legislature also said the agency must consider “access to care.”

Attorneys for the providers and families who sued to block the cuts argued the obvious: Cutting payments will cause some providers to drop out of the market. They say as many as 60,000 kids won’t get the services they need.

They made a better case. State District Judge Tim Sulak granted a temporary injunction saying the cuts cannot take effect Oct. 1 as planned. The judge said he was convinced that the rate reduction would place the health of children in jeopardy.

The state may appeal.

The case might have gone a little better for the commission if it had presented some sort of study from a respectable source saying access to care would be maintained.

The commission admitted in court Monday that it had no such study.

Texas A&M studied other issues for the commission, but examining access to care was not part of the contract.

It’s the Legislature’s job to write the state budget. Lawmakers can order cuts in specific programs, as they did in this case.

But the legislators also said access to care should be taken into account — after all, they didn’t want to seem heartless. That’s sufficient warning to the commission to tread carefully.

The commission should have come to court better prepared.