The Drumbeat Gets Louder: Texas Needs a Medicaid Expansion

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We already know that roughly 60 percent of Texans believe Governor Perry should expand Medicaid in Texas – something the Affordable Care Act will make possible and, for the most part, pay for. But Perry has been digging his heels in, even as Republican governors around the country have come around after realizing that the benefits it would bring to their states are too good to pass up. Now the editorial board of nearly every major paper in Texas has also called on the governor for an expansion. Some highlights:

Corpus Christi Caller:

“Gov. Rick Perry almost could argue that his consistent refusal to expand Medicaid in Texas is a principled stand. If only it weren't fatal. According to one esteemed estimate, the annual unnecessary death toll for continuing to leave a fourth of Texans uninsured is 9,000.”

San Antonio Express-News:

“If Texas Republican leaders reject that funding in protest of the health care law, the health care needs of those it would cover still exist. All that changes is who pays for their care – local governments and hospitals, who pass along the costs in higher taxes and higher fees reflected in health insurance premiums.”

Houston Chronicle:

“Expanding Medicaid statewide, and paying for clinic visits long before a patient is hauled away in an ambulance, is both the cheapest option and the best for keeping Texans healthy. If we say no thanks to the federal matching money, as Gov. Perry plans, Texans will continue to pay for federal health-care reform; we just won't get any of the benefits. Our tax dollars will foot other states' bills. And without the federal matching funds, it's hard to see how our cash-strapped state government could begin to fix our broken system.

Longview News Journal:

“All the political posturing gets us nowhere. Legislators are being presented with a challenge they must meet. If we think the state's health care system needs some work now, it will be a true disaster if the Legislature does not act before it adjourns.

Fort Worth Star Telegram:

“It's no secret that the Texas Legislature shortchanged Medicaid by about $6 billion in the last session as a way to close other budget shortfalls. Refusing to accept federal taxes paid by Texans only exacerbates what is already a dubious distinction for the state: Texas has the highest number of uninsured people in the country.”

Dallas Morning News:

“Budget writers in Austin are understandably worried about adding $15 billion in Medicaid costs over the next decade… But there's more to this story than the $15 billion price tag. The state and communities already are financing the costs of covering these uninsured Texans. They're just doing it in other, often less efficient, ways.”

Austin American-Statesman:

“A key question lawmakers should ask is whether the cost is more significant than the costs that will shift to insured Texans and Texas taxpayers if millions of Texans remain uninsured and continue to rely on emergency rooms for even minor medical care. Hospitals pass along the costs of treating uninsured patients to insured patients. Taxpayers in hospital districts, such as Travis County's Central Health, absorb the cost in the form of higher tax rates.”

Joining a majority of Texans and Texas newspapers are now business leaders as well. Chambers of Commerce of five cities (El Paso, Dallas, San Antonio, Fort Worth and Arlington) – typically on the side of Perry – are also calling for a Medicaid expansion. From Bloomberg:  

“The chambers of five cities are sending lobbyists to press Republican leaders to increase Medicaid coverage under President Barack Obama's health-care law. Businesses are often allied with Perry, a failed contender for last year's Republican presidential nomination. The chambers, however, argue Texas shouldn't pass up $100 billion over the next decade to cover 1.5 million adults…

'This may be the only time that we have taken an actual formal position that is opposite that of the governor,' said Richard Dayoub, chief executive officer of the El Paso Chamber of Commerce. 'I don't know of any issue that has created so much concern across the state and has amassed so much support across party lines and throughout the business sector'…

Refusing to expand Medicaid could cost Texas employers as much as $448 million in fines because the 2010 law penalizes some companies when workers can't obtain affordable coverage, Jackson Hewitt Tax Service Inc. said in a March 13 report.”

Rejecting a Medicaid expansion means rejecting an opportunity to insure 2 million more Texans,  draw down $100 billion funds and avert other massive costs like emergency room visits for the uninsured and fines for Texas companies who can't afford to provide insurance. Not because of morality or good policy – but because of lingering bitterness that the Affordable Care Act became a law.  

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About Author

Emily Cadik

Emily is a Texas ex-pat and proud Longhorn living in Washington, DC, where she remains connected to the Lone Star State through her work on BOR and her enthusiasm for breakfast tacos. She works on affordable housing policy, and writes about health care, poverty and other social justice issues.

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