HOUSE CONCURRENT RESOLUTION
1-1 WHEREAS, The Texas-Mexico border region suffers from an
1-2 inadequate medical infrastructure that has led to disparities in
1-3 access to health care between the border region and the rest of the
1-4 state; and
1-5 WHEREAS, Statewide in 1998, there was an average of 270
1-6 Medicaid-eligible patients for every physician participating in the
1-7 Medicaid program, but in the border counties where there were
1-8 participating physicians, the number of eligible patients per
1-9 physician ranged from a low of 416 in El Paso County to a high of
1-10 1,361 in Starr County; in two counties, Presidio and Zapata, there
1-11 were no participating physicians at all to serve the
1-12 Medicaid-eligible population; and
1-13 WHEREAS, The border region historically has had high
1-14 patient-to-physician ratios, resulting in limited access to health
1-15 care services and reduced utilization rates for these services; in
1-16 addition, the availability of medical care in Mexico may also
1-17 reduce utilization rates for the region; and
1-18 WHEREAS, Low utilization rates along the border create a
1-19 distorted assessment of the actual demand for services and
1-20 inappropriately drive down the capitated reimbursement rates for
1-21 both Medicaid and the Children's Health Insurance Program (CHIP);
1-22 and
1-23 WHEREAS, The average per-recipient reimbursement for the
1-24 border region is 16 percent less than the statewide average, which
2-1 creates a disincentive for health care providers to locate and
2-2 provide services to Medicaid clients in the region; furthermore,
2-3 low reimbursement rates complicate already limited access to health
2-4 care as existing providers either leave the program or limit their
2-5 participation; and
2-6 WHEREAS, Current Medicaid and CHIP reimbursement rates simply
2-7 trap the Texas-Mexico border counties in a cycle of limited access
2-8 to care, low utilization rates, and low reimbursement rates, all of
2-9 which further damage the medical infrastructure of the region and
2-10 create greater barriers to health care access for Medicaid and CHIP
2-11 clients; and
2-12 WHEREAS, The unique issues facing the border may not be
2-13 apparent when evaluations of the state as a whole mask
2-14 discrepancies between the border and the rest of the state;
2-15 calculating the federal share of the state's Medicaid costs, or the
2-16 Federal Medical Assistance Percentage (FMAP), using the state's per
2-17 capita income may not provide an accurate assessment of the border
2-18 region's needs; and
2-19 WHEREAS, Establishing a separate FMAP for the border region
2-20 would recognize these unique circumstances and allow current state
2-21 Medicaid funding in the region to draw down additional federal
2-22 funds that would help eliminate the reimbursement disparity; and
2-23 WHEREAS, Unless this disparity is resolved, the region will
2-24 continue to suffer from an inadequate health care infrastructure
2-25 that is unable to address the medical needs of the border
2-26 residents; now, therefore, be it
2-27 RESOLVED, That the 77th Legislature of the State of Texas
3-1 hereby respectfully urge the Congress of the United States to
3-2 establish a separate Federal Medical Assistance Percentage for the
3-3 Texas-Mexico border region; and, be it further
3-4 RESOLVED, That the Texas secretary of state forward official
3-5 copies of this resolution to the president of the United States, to
3-6 the speaker of the house of representatives and the president of
3-7 the senate of the United States Congress, and to all the members of
3-8 the Texas delegation to the congress with the request that this
3-9 resolution be officially entered in the Congressional Record as a
3-10 memorial to the Congress of the United States of America.
Chavez
Gutierrez
_______________________________ _______________________________
President of the Senate Speaker of the House
I certify that H.C.R. No. 214 was adopted by the House on May
5, 2001, by a non-record vote.
_______________________________
Chief Clerk of the House
I certify that H.C.R. No. 214 was adopted by the Senate on
May 22, 2001, by a viva-voce vote.
_______________________________
Secretary of the Senate
APPROVED: __________________________
Date
__________________________
Governor