Fed agency ranks Texas at bottom for health care

AUSTIN, Texas (AP) — Texas ranks worst in the nation in health care services and delivery, according to an annual scorecard issued by the federal Agency for Health Care Research and Quality.

In nine out of 12 categories, Texas rated weak or very weak. The only area where Texas earned the above average ranking of "strong" was in maternal and child health care measures. Out of a possible 100 points, Texas earned 31.61, while Minnesota, the highest ranking state, scored 67.31.

The agency identified 155 areas where it could compare the quality of health services across the country, such as infant mortality and obesity rates. Researchers used that data to generate both national and regional averages for each area, and they then compared each state to the national and regional averages to generate a score.

The report is designed to help politicians, policy makers, private insurers and state and federal agencies identify strengths and weaknesses in state health care programs.

Stephanie Goodman, spokeswoman for the Texas Health and Human Services Commission, said Thursday that the report goes far beyond what state agencies control, but she said it demonstrates the need to improve access to preventive health care.

"Late last year Texas received approval for a new effort that will help fund innovative local projects," she said. "Hospitals and other health care providers have come together to form regional partnerships, and they'll soon be sending the state their plans for making better use of Medicaid funds to expand access to preventive services and reduce the need for expensive emergency room care."

Texas scored particularly poorly in the home health care category, with the study finding that the state provided little support to the elderly and disabled who chose to live at home. Texas also ranked weak or very weak in preventive, acute and chronic care delivery.

The state's scores slipped from last year in treating cancer and diabetes patients.

The Texas Medicaid law for the disabled and poor offers one of the most limited health care programs in the nation, and more than 25 percent of Texans do not have health insurance of any kind, which is the highest uninsured rate in the nation.

The poor state of the Texas health care system has particular relevance as state lawmakers begin to consider how to respond now that President Barack Obama's federal health care overhaul has been upheld by the U.S. Supreme Court.

Republicans, who control every statewide office and represent a majority in the Legislature, have rejected the new federal law, which calls for almost every eligible U.S. citizen to get health insurance. Some have pledged to block any effort to expand Texas Medicaid, which is a joint state and federal program, in order to get more people insured.

Last year, Texas lawmakers underfunded Medicaid by more than $4 billion and that bill will come due when they meet again next year. Top officials have estimated that the Legislature will need to find at least $10 billion in new funding for Medicaid at a time when Gov. Rick Perry has pledged not to increase state spending.

Democrats have called on the state to close tax loopholes to raise more money for both health care and education programs.

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Where health care ranks among biggest Supreme Court decisions

The Supreme Court’s divided decision on health care reform might take years to evaluate. As the case is probably far from done when it comes to legal actions, where does it stand in historic terms?

Supreme_Court_of_the_United_StatesOfficially, the case is known as National Federation Of Independent Business v. Sebelius, and it upheld most of President Barack Obama’s health care agenda, with the exception of some Medicaid provisions.

The health care decision could have far-reaching social and economic effects for years, and it will enter the short list of decisions known by most Americans, by a few words, such as Miranda, Dred Scott, Roe v. Wade and Bush v. Gore.

As a yardstick, here is a short list what many experts consider as landmark court decisions. Some of these cases are still be contested today, which bodes as a sign for the health care case.

To be sure, there are many other decisions that were very important, but a handful of decisions are usually mentioned in any discussions of landmark cases.

Note that two of these 15 landmark cases were reversed over time: one by the amendment process, the other by the Supreme Court.

Marbury v. Madison (1803) The mother of all landmark Supreme Court decisions, it established the court’s ability to overrule acts of Congress that were in conflict with the Constitution.

McCulloch v. Maryland (1819). The court decided the federal government can use any means the Constitution doesn’t forbid, and state governments can’t block the actions of the federal government.

Dred Scott v. Sandford (1857). The decision that drove the nation closer to Civil War. The court decided blacks couldn’t be U.S. citizens and had no standing to sue in federal courts. Two amendments overturned this decision after the war.

Plessy v. Ferguson (1896). The case established segregation as legal under the concept of separate but equal facilities. It was overturned in the 1950s.

Korematsu v. United States (1943). The ruling upheld the American policy of holding Japanese-Americans in interment camps.

Brown v. Board of Education (1954-1955), The court found segregated schools were unconstitutional in violation of the 14th Amendment. It also rejected the “separate but equal” doctrine adopted in Plessy v. Ferguson.

Gideon v. Wainwright (1963). The ruling found that defendants without money must be provided representation without charge.

Miranda v. Arizona (1966). The court said police must advise criminal suspects of their rights to remain silent, to have a lawyer and to have one appointed if a suspect can’t afford an attorney.

Roe v. Wade (1973). The decision struck down some laws restricting abortion, especially in the early parts of pregnancy. The decision has been revised in other challenges but not repealed.

Univ. of Cal. v. Bakke (1978). The court decided race could be used as a factor in college admissions but quotas based on race weren’t allowed.

Texas v. Johnson (1989). The court ruled that offensive acts such as flag burning are protected by the First Amendment as freedom of speech.

Bush v. Gore (2000). The decision stopped the recount of presidential election ballots in Florida, settling the 2000 election.

Lawrence v. Texas (2003). The court found state laws unconstitutional laws that penalize adults who engage in consensual same-sex acts.

Citizens United v. Federal Election Commission (2010). The court allowed corporations and unions to spend on certain political campaigns without limits under the First Amendment.

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Health centers for poor, uninsured see ranks swell

WASHINGTON (Reuters) - Community health centers that cater to the poor and uninsured saw their patients' ranks swell by nearly 18 percent from 2008 to 2011 as job loss left more Americans without health insurance, the Obama administration said on Tuesday.

A report released by the White House said 20 million Americans now receive healthcare services through 8,500 community health centers, up from 17 million four years ago.

"Those numbers really took a big jump," Mary Wakefield, who heads the U.S. Health Resources and Services Administration, told reporters. "A lot of those folks were people who, when they lost their jobs early on, lost their coverage."

The administration said health centers were able to accommodate larger numbers of patients because of funding provided by President Barack Obama's embattled healthcare reform law and the administration's earlier economic stimulus package.

The report, the latest in a series of government releases aimed at underscoring the value of healthcare reform, surfaced as the U.S. Supreme Court deliberates about the future of the law known as the Patient Protection and Affordable Care Act.

Community health centers, which often serve low-income areas where there are few doctors or hospitals, provide a cornerstone for the law's goal of expanding healthcare access to more than 30 million uninsured Americans.

The ranks of the uninsured, which equaled 1-in-4 Americans last year, pose major social and financial challenges for the $2.6 trillion U.S. healthcare system.

But the high court could overturn the reforms in a ruling expected next month, ending the administration's plans to expand coverage and much of its support for community health centers.

The law also faces repeated election year calls for repeal from Republican politicians who call it government over-reach and a potential drag on the economy.

The administration also announced on Tuesday that it had awarded $728 million in grants for about 400 renovation and construction projects at community health centers. Officials said the funding would allow another 860,000 people to gain access to medical services.

Community health centers are nonprofit groups that serve patients with low incomes, including people with no insurance, limited English proficiency, migrant and seasonal farm workers, the homeless and people living in public housing.

All told, the Obama administration has now allocated $1.5 billion to support major construction and renovation projects at community health centers.

The ranks of health center patients are expected to grow by another 1.3 million people over the next two years, the White House report said.

(Editing by Vicki Allen)

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