1-1 By: Chavez (Senate Sponsor - Shapleigh) H.C.R. No. 214 1-2 (In the Senate - Received from the House May 7, 2001; 1-3 May 7, 2001, read first time and referred to Committee on Business 1-4 and Commerce; May 10, 2001, reported favorably by the following 1-5 vote: Yeas 6, Nays 0; May 10, 2001, sent to printer.) 1-6 HOUSE CONCURRENT RESOLUTION 1-7 WHEREAS, The Texas-Mexico border region suffers from an 1-8 inadequate medical infrastructure that has led to disparities in 1-9 access to health care between the border region and the rest of the 1-10 state; and 1-11 WHEREAS, Statewide in 1998, there was an average of 270 1-12 Medicaid-eligible patients for every physician participating in the 1-13 Medicaid program, but in the border counties where there were 1-14 participating physicians, the number of eligible patients per 1-15 physician ranged from a low of 416 in El Paso County to a high of 1-16 1,361 in Starr County; in two counties, Presidio and Zapata, there 1-17 were no participating physicians at all to serve the 1-18 Medicaid-eligible population; and 1-19 WHEREAS, The border region historically has had high 1-20 patient-to-physician ratios, resulting in limited access to health 1-21 care services and reduced utilization rates for these services; in 1-22 addition, the availability of medical care in Mexico may also 1-23 reduce utilization rates for the region; and 1-24 WHEREAS, Low utilization rates along the border create a 1-25 distorted assessment of the actual demand for services and 1-26 inappropriately drive down the capitated reimbursement rates for 1-27 both Medicaid and the Children's Health Insurance Program (CHIP); 1-28 and 1-29 WHEREAS, The average per-recipient reimbursement for the 1-30 border region is 16 percent less than the statewide average, which 1-31 creates a disincentive for health care providers to locate and 1-32 provide services to Medicaid clients in the region; furthermore, 1-33 low reimbursement rates complicate already limited access to health 1-34 care as existing providers either leave the program or limit their 1-35 participation; and 1-36 WHEREAS, Current Medicaid and CHIP reimbursement rates simply 1-37 trap the Texas-Mexico border counties in a cycle of limited access 1-38 to care, low utilization rates, and low reimbursement rates, all of 1-39 which further damage the medical infrastructure of the region and 1-40 create greater barriers to health care access for Medicaid and CHIP 1-41 clients; and 1-42 WHEREAS, The unique issues facing the border may not be 1-43 apparent when evaluations of the state as a whole mask 1-44 discrepancies between the border and the rest of the state; 1-45 calculating the federal share of the state's Medicaid costs, or the 1-46 Federal Medical Assistance Percentage (FMAP), using the state's per 1-47 capita income may not provide an accurate assessment of the border 1-48 region's needs; and 1-49 WHEREAS, Establishing a separate FMAP for the border region 1-50 would recognize these unique circumstances and allow current state 1-51 Medicaid funding in the region to draw down additional federal 1-52 funds that would help eliminate the reimbursement disparity; and 1-53 WHEREAS, Unless this disparity is resolved, the region will 1-54 continue to suffer from an inadequate health care infrastructure 1-55 that is unable to address the medical needs of the border 1-56 residents; now, therefore, be it 1-57 RESOLVED, That the 77th Legislature of the State of Texas 1-58 hereby respectfully urge the Congress of the United States to 1-59 establish a separate Federal Medical Assistance Percentage for the 1-60 Texas-Mexico border region; and, be it further 1-61 RESOLVED, That the Texas secretary of state forward official 1-62 copies of this resolution to the president of the United States, to 1-63 the speaker of the house of representatives and the president of 1-64 the senate of the United States Congress, and to all the members of 2-1 the Texas delegation to the congress with the request that this 2-2 resolution be officially entered in the Congressional Record as a 2-3 memorial to the Congress of the United States of America. 2-4 * * * * *