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Texas Wants a Medicaid Expansion. Why Doesn't the Governor?


by: Emily Cadik

Fri Feb 08, 2013 at 04:00 PM CST


Now that we're three years into Affordable Care Act implementation , dozens of states are signing up to benefit tremendously from a huge Medicaid expansion - an expansion whose bill is almost entirely footed by the federal government.  But not Texas.  

As part of the Affordable Care Act, by January 1, 2014, all families up to 133 percent of the federal povery line would be eligible for Medicaid.  The federal government would fund 100% of the cost of expanding coverage to these families for the first three years, after which it would provide $9 for every $1 spent by the state. So if Texas invests $15 billion over 10 years, it would be able to draw down $100 billion in federal funds and insure up to an additional 2 million Texans.  But the Supreme Court ruled in 2012 that states can opt out of the expansion - much to the delight of Rick Perry.  

As with so many issues, public opinion in Texas is not on Rick Perry's side of this issue.  According to an American Cancer Society Action Network poll, 59 percent of Texans believe Medicaid services should be expanded under the Affordable Care Act.  And both the Texas Medical Association and Texas Hospital Association have come out in support of the expansion, partly for all of the usual public health reasons, but also because of the economic benefit to the state.

Despite all of the posturing against Obamacare, six Republican governors have since caved on Medicaid expansion, which we covered recently on BOR.  Because even the most conservatives leaders (e.g. Jan Brewer of Arizona) are beginning to realize that it's a pretty good deal for their states.  

State Rep. Eric Johnson (D-Dallas) has filed legislation (House Bill 999) to expand Medicaid in accordance with the Affordable Care Act.  He has also filed a bill to allow Dallas County to expand Medicaid on its own (House Bill 1001).  According to Rep. Johnson, "Millions of Texans remain uninsured. We must seize the opportunity that has fallen in our lap to remedy that problem. If we choose not to adopt Medicaid eligibility expansion, our federal tax dollars will effectively be spent on other states' health care programs. This is the right thing to do whether you're looking at it from a moral standpoint or a fiscal one."

It's good to know that some Texas leaders are willing to vocally come down on the right side of what should be an easy issue.  Unfortunately, Governor Perry still has to sign any bills before they become law.  

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