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A recent article about Medicaid in the Houston Chronicle repeated some of the political musings of Governor Rick Perry and other politicians. For anyone with even a basic knowledge of Medicaid, the suggestion that Texas could simply "opt-out" is ridiculous.

Of course that doesn't stop politicians from proposing it, and thereby frightening the poor, the elderly, and the young Texans who rely on Medicaid for medical and nursing home care.

The article prompted an excellent response from Molly Dear Abshire, who is a Certified Elder Law attorney, and practices at the Wright Abshire law firm in Houston. This is her letter to the editor:

The recent article, ?No Medicaid in Texas,? published on the front page of the Sunday, November 14, 2010 edition of the Houston Chronicle, exemplifies the sensitive subject of providing healthcare and healthcare reform in the nation. In the article, divisive rhetoric made by Gov. Rick Perry and other Republican state senators merely serves as political posturing and offers little in the way of solutions to the budget crisis facing state and local economies.

A common misperception of Medicaid is that program beneficiaries are only the indigent and undeserving. However, the majority of individuals who receive Medicaid benefits are the elderly, children and the developmentally disabled. These are people lacking a voice in the political process. Politicians calling for an opt-out from the federal Medicaid program offer little hope for improving the quality of care received by Medicaid recipients and fail to provide alternatives to the Medicaid program. Simply calling for a private health insurance solution is unfeasible and irresponsible.

Long-term care Medicaid goes beyond the payment of nursing home expenses, and less costly ?waiver? programs are underfunded. Waiver programs, such as the Community Based Alternatives (?CBA?) and the Community Living Assistance and Support Services (?CLASS?) programs, provide healthcare and rehabilitative services in the Medicaid recipient?s home. These have been touted as more cost effective than nursing home care and, when appropriate, allow the individual to stay at home indefinitely. However, due to lack of funding and a lack of providers, these waiver programs have waiting lists of up to 10 years. Will this be the future for the elderly and disabled citizens of Texas?

What politicians fail to consider when seeking to opt-out of the Medicaid program is the severe toll such action would take upon families of long-term care Medicaid recipients. Often such recipients have elderly spouses who are physically unable to meet the needs of their spouse. In addition to the physical care-giving demands of the incapacitated spouse, the financial burden of providing care to the incapacitated spouse jeopardizes the ?well? spouse?s ability to provide the basic necessities of life. With the average cost of nursing home care hovering at $4,500 per month, most couples quickly deplete their life savings to fund such care, leaving the spouse living outside of the nursing home in a meager existence.

If the Medicaid recipient is unmarried, their adult child, children or other close family members take on the burden of care. They often have minor children or employment, which makes providing adequate care for their incapacitated loved one impossible. Frequently, adult children do not live near their parents and are unable to move closer to provide care. Placement in a nursing home is sometimes the only option for giving the elderly or disabled individual the care they need. Therefore, the reality is that without the Medicaid program, vital nursing home care would be unattainable.

Statements like those made in Sunday?s article serve only to create additional stress and uncertainty among a disadvantaged group. As president of the Texas Chapter of the National Academy of Elder Law Attorneys, and as an attorney in a firm specializing in servicing the needs the of elderly and disabled, my office is receiving calls from Medicaid recipients and their families who are terrified at the prospect of losing the Medicaid program?s life-saving benefits. Not only do long-term Medicaid benefits provide nursing home care for the recipient, but they also provide relief to the family who cannot afford nursing home care and is unable to care for the Medicaid recipient at home.