If you want to fix Texas' Medicaid managed care, listen to those suffering in the system
What seems clear is that it'll be up to lawmakers to fix the gaping holes in this mess of a complex system and hold these companies accountable for doing the job they're being paid billions to do.
Alongside her medically fragile 3-year-old son D'ashon Morris, Linda Badawo of Mesquite testifies before members of the Texas House Committee on Human Services on Wednesday, June 20, 2018. D'ashon was denied private duty nursing despite emphatic protests from Linda, his doctors and nurses.(Tom Fox / Staff Photographer)
By Dallas Morning News Editorial|
3:46 PM on Jun 26, 2018 CDT
After the horror stories revealed in this newspaper about how for-profit companies are failing tens of thousands of Texans in the state's managed-care Medicaid system, we had hoped to hear a little contrition in a recent Austin hearing.
Instead, what we got was a whole lot of defensiveness and shocking refusals by company execs to take responsibility for shortcomings in the care they provide for some of the state's most chronically ill children, as well as the disabled and elderly.
What seems clear is that it'll be up to lawmakers to fix the gaping holes in this system, starting with holding these companies accountable for doing the job they're being paid billions to do.
Rep. Richard Raymond, a Democrat from Laredo, called a House committee hearing last Wednesday in response to The Dallas Morning News' "Pain and Profit" series. That series revealed that the state's managed-care system was suffering from inadequate oversight, not enough doctors and a shortage of accountability. Currently, companies can reap large profits even while cutting costs on care to the state's most fragile and vulnerable.
We're disappointed that mostly company executives and state human services officials were invited to speak at last week's hearing. It seemed more designed to give companies a platform to attack The News' findings than to get to the bottom of breakdowns in the system.
For example, The News pointed out that the way Superior HealthPlan paired severely sick children with one nurse violated state and federal law. Rather than acknowledge that and other facts, the company's CEO, Mark Sanders, said, "The articles make numerous incorrect and misleading assertions about how Medicaid managed care works in Texas."
The fact is that these stories hold up. Officials in private industry and in state office have been scrambling to respond even before these articles were published because of the reporting done for this series.
That reporting found such things as D'ashon Morris, a baby who suffered brain damage after being denied round-the-clock nursing care by Superior.
D'ashon's adoptive mother, Linda Badawo, took on the onerous task of transporting D'ashon, now 3, from Mesquite to Austin for the hearings. She was the only parent or patient invited to speak last week, but she isn't the only voice that will ultimately he heard.
There is another hearing planned for Wednesday this week. And a state inspector general is probing both D'ashon's case and the question of whether the state conducted proper oversight of Superior.
The Texas Health Commission is also hiring 98 people who will be dedicated to strengthening the state's Medicaid system. So there will be more nurses and more people conducting oversight.
That's great, but there is still a lot of work to be done. Currently, the managed-care system isn't working for those who need it the most. Lawmakers won't have a clear picture of how broken the system is until they hear more from those who are suffering in it now.
"They've misrepresented the facts in all of these cases to make us look very bad." — David Harmon, medical director Superior HealthPlan.
"I strongly believe that they don't have any passion for what they do. ... Superior is 100 percent responsible." — Linda Badawo, mother of toddler D'ashon Morris.
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