Dr. Javier Saenz, a family physician in La Joya, has exhausted his personal savings and has had to extend his credit line to keep his small business afloat. Saenz, like many other Texas physicians, treats a disproportionately high number of the roughly 330,000 senior patients who are eligible for both Medicare and Medicaid. On Jan. 1, Texas followed the lead of several other states by ending the practice of using Medicaid funds to pay for dual eligible patients' deductible, which is $140 this year. Lawmakers also changed doctors' co-pays for Medicare Part B services. The state now limits its reimbursements to doctors treating dual eligible patients to the Medicaid allowable, which tends to be lower than Medicare rates.