On his blog this past week, State Representative Garnet Coleman allayed the fears of some liberals about Medicaid, showing that there is optimism on this issue specifically. See; Republicans are budget hawks and pocketbook hawks. Even if they don't care about Texans living the healthiest lives possible, they may allow Medicaid Expansion for money's sake, if nothing else.
It turns out that opposing Medicaid Expansion might be easier said than done, as more Republicans are coming around to the idea that Expansion is the right thing to do.
The reason I have been a leader on this issue is because I am confident that we can develop a bipartisan solution that results in a Medicaid Expansion here in Texas. My optimism is based on the fact that everyone, no matter which side of the aisle they are on, wants to do what is in the best interests of the state. It is increasingly hard to justify sitting on the sidelines while other states, including very Republican ones, acknowledge the benefits and move forward with the program expansion.
First, refusing to participate in the Medicaid expansion is expensive. It won't just cost the state money, it will cost the millions of Texans who are insured money as well, as providers find ways to offset the cost of providing uncompensated care. Our tax dollars are already being spent on the program; it doesn't make sense to refuse to accept what we are already buying.
Further, refusing to participate in the expansion would deny benefits to U.S. citizens that will be available to legal immigrants. This is due to the fact that the ACA was drafted with the assumption that all states would expand their Medicaid programs and included a provision that allows legal immigrants to access federal subsidies to purchase private insurance, since they are not allowed to obtain Medicaid for their first five years of legal residency. Thus, if a state does not expand its Medicaid program, legal immigrants will have better access to care than low-income United States citizens.
Therefore, I am not surprised by Republican Governor Jan Brewer's announcement last week that Arizona will indeed participate in the Medicaid Expansion as provided by the ACA. She correctly acknowledges that refusing to participate in the expansion, childless adult citizens who are under 100% of the federal poverty level would not have access to coverage; Arizona tax dollars would leave the state to pay for the implementation of states that do participate in the expansion; and Arizona businesses, taxpayers, and health providers would be directly responsible for the uninsured Arizonans who do get hurt and receive care.
I applaud Governor Brewer's decision to do what is best for the state of Arizona. She refused to let partisan gamesmanship get in the way of doing what is right. I hope our Republican leadership in Texas can do the same.
Garnet Coleman has been a Democratic State Representative since 1991. Coleman has served on the House Public Health committee, and he has received recognition from multiple health advocacy organizations.