Last week, Republicans in the House of Representatives made their 37th attempt to repeal the Affordable Care Act. Despite the fact that 12 percent of Americans think the Affordable Care Act has been repealed and 23 percent don't know, the measure was entirely symbolic to show that Republicans are fighting the law's implementation every step of the way. It's also symbolic of the Republican strategy to reject anything supported by Democrats without offering a better solution.
Underscoring this point, in remarks on the House floor,Rep. Lloyd Doggett (D-Austin) said, "Together, we could provide more cost-effective care and do something more about spiraling healthcare costs. But really, the only true Republican alternative to Obamacare is Nothingcare."
The same goes for Governor Perry's resistance to expanding Medicaid in Texas. Perry and his allies continue to reject the federal dollars that would allow us to insure potentially 2 million more Texans, but have not offered a proposal that would make anywhere near as much of a dent in Texas' highest uninsured rate in the nation.
Texas Lunch Links is a lunchtime buffet of Texas News and Views with a heavy emphasis on happenings at the Texas Legislature.
WATER: Groundwater in Texas' major aquifers dropped significantly between 2010 and 2011 as a result of drought conditions, and groundwater levels are expected to continue declining.
FRACKING: Texas counties are seeking more authority to regulate the location of fracking water disposal wells and searching for ways to mitigate environmental damage that might be caused by the disposal of frack water.
A few years ago, Oregon was able to add 10,000 more residents to its Medicaid rolls, even though it had to leave 80,000 people in need off. Since the 10,000 were selected through a lottery, the situation made for an ideal randomized experimental design for comparing outcomes between the new Medicaid enrollees and the uninsured.
Last week, the second batch of results from the experiment was released, showing that those with Medicaid were consuming more health care - especially preventative care. According to the Washington Post, "Here's what we can say with certainty: Medicaid works as health insurance."
But it's not just the increase in care that set the new Medicaid patients apart from those without health insurance. Other benefits included:
A 30 percent decrease in depression rates,
A decrease in the percent of participants who faced out-of-pocket medical expenses totaling more than 30 percent of their annual income from 5.5 percent to 1 percent, and
A 50 percent decrease in the likelihood of experiencing financial strain, like delaying payments on other bills or taking out loans to cover medical expenses.
Read about the conservative response after the jump.
The refrain we keep hearing from Perry and company is that Texas just doesn't need a Medicaid expansion - we don't have much to gain and we already have a solid health care network. But as it turns out, the state has basically been taking federal money away from state-run hospitals and using it to fill its own budget shortfalls.
Texas is diverting millions of dollars of federal money intended to reimburse three state-owned hospitals for uninsured care and shortfalls in Medicaid payments, University of Texas officials say. That money, which is rerouted into a general fund, otherwise would offset expenses that the University of Texas Medical Branch, M.D. Anderson and UT Tyler incur providing care for the uninsured...
The intent of the federal programs is for the state and federal governments to repay the hospitals, but Texas contributes no money and instead forces the state hospitals to provide the state's contribution, then takes the federal contribution for the general fund. The hospitals are never compensated for the cost of caring for the uninsured and for shortfalls in Medicaid payments, according to officials at UTMB, UT Tyler and the Texas Health and Human Services Commission.
Failure to reimburse hospitals means they can serve fewer uninsured patients. They're turning people away that they're supposed to be able to help, and are even receiving money to help.
And it keeps getting worse. For instance, according to the Texas Observer:
In 2011, UTMB denied 91 percent of uninsured Texans seeking medical care, according to a new report from a nonprofit coalition advocating for Galveston County's uninsured residents. That's a sharp increase; in 2005, UTMB turned away just 35 percent of uninsured people seeking care.
Unfortunately, taking the funding for the uninsured for other purposes has been the legislature's band-aid for budget issues since 1986. Rick Peters, bureau chief of the former Texas Department of Health, now the Department of Health Services, from 1986 to 1999, says, "That's how that budget crisis got solved... That freed up a bunch of money to be rolled back to the general fund."
Expanding Medicaid would insure millions of additional Texans - Texans who are more and more often being turned away by hospitals. But according to the Governor, Senator Cruz, Senator Cornyn and many in the Texas legislature, our state doesn't really need it.
On April 1, Governor Perry and Senators Cornyn and Cruz hosted a press conference and issued a joint press release, in which they again made the flimsy case against Medicaid expansion. Sadly, it was not an April Fools joke.
In the press conference, Perry claimed that, "In Texas, only three out of every ten doctors are accepting new Medicaid patients, and we fear that number may actually decrease if expansion went through." His numbers are just wrong.
Today's a big day in the Legislature, as the Texas House of Representatives debates HB 5, aka The Budget. Debate is scheduled to start at 9 a.m. and probably won't wrap up until late, late at night.
What to watch for:
Funding Education: Which Democrats push to add funding to education? How much funding?
False Choices: What sucker votes will Republicans try to force in order to make Democrats choose between priorities?
Family Planning: Last year the Republican legislature slashed funding from women's health and family planning. Will they repeat the effort or will they try to restore funding?
Of course, there is also also a plethora of terrible, embarrassing amendments filed by Republicans. Will the basest elements of the GOP prevail?
Homophobia and Misogyny: Rep. Bill Zedler filed an amendment to eliminate LGBT resource centers on state university and college campuses. The amendment would also eliminate state funding for women's centers and all gender and sexuality centers at Texas universities.
Stem Cell Research: Rep. Jonathan Stickland wants to defund embryonic stem cell research. This would prohibit research projects funded by National Institutes of Health and by private sources from being conducted in any state-owned research institutions.
Frosh Assault: Right-wing GOP freshman are planning an "assault" on the budget, trying to defund crucial programs under the guise of shoring up the Teacher's Retirement System. FYI, the Teachers are all "thanks, but no thanks."
Below the jump, follow it all with our CoverItLive Liveblog of the proceedings, tracking progressive organizations and several Democratic representatives.
We do our best, but we can't cover everything. To fill in the gaps, please enjoy Texas Lunch Links, a lunchtime buffet of links to Texas-related news and views.
PERRY LIES: Rick Perry's statement that, "only three in 10 Texas doctors accept new Medicaid patients" is mostly false, according to PolitiFact Texas.
NO TWEET FOR YOU: A bill filed by Republican State Representative Todd Hunter of Corpus Christi would prohibit government officials from tweeting, Facebook-ing, sending emails, instant messages, and text messages during public meetings.
TOLL ROADS: Republican State Senator Donna Campbell has a bill in the hopper that would prohibit existing state roads from being converted to toll lanes
TEXAS CANCER COALITION: Attorney General Greg Abbott is investigating whether the Cancer Prevention and Research Institute of Texas had the authority to alter its mission and change its name to the Texas Cancer Coalition.
DPS CONTROVERSY:The Statesman reports that Texas Department of Public Safety employees have been commuting from home at taxpayer expense in apparent violation of DPS rules. DPS sets a 30-mile limit on reimbursements for employees who drive state-owned vehicles.
The good news: there seems to be an admission that Texas' uninsured rate is too high, and that our goal should be to lower it. There is also an acknowledgement that the Affordable Care Act (ACA) will significantly lower our uninsured rate. Baby steps.
The arguments against Medicaid expansion, however, fall woefully short.
The main argument against it is that the ACA will already lower Texas' uninsured rate from 24 percent to around 15 percent through the creation of insurance exchanges (and without the Medicaid expansion) - a huge drop that should basically suffice for now. Rep. Kolkhurst admits the rate would drop even lower to 12 percent with the Medicaid expansion - which her estimates say will insure somewhere between 522,000 and 776,000 low-income Texans (out of the 1.4 million people eligible). So why not go for the expansion, after admitting that there are at least half a million people below the poverty line who will not be covered without a Medicaid expansion?
Rep. Kolkhorst thinks Texas is already doing enough. She points to the recently implemented 1115 Medicaid waiver, which she says would expand community clinics. She also adds that we have a robust system of federally qualified health centers. Community health centers and clinics are valuable resources, especially in low-income communities. They are not, however, substitutes for health insurance.
Sadly, Rep. Kolkhorst and Governor Perry think thinks the lowest Texas' uninsured rate could possibly get is 12 percent, even with full ACA implementation and a Medicaid expansion. Almost half of the states already have uninsured rates below 12 percent without the ACA fully implemented, and even more will fall into this camp once they realize the full benefits of the law.
Without the Medicaid expansion - and dropping to only 15 percent uninsured at best - Texas will likely retain its shameful distinction of having the highest uninsured rate in the nation.
On Monday Texas politicians redrew battlelines over the proposed Medicaid expansion in Texas. Governor Perry, and U.S. Senators John Cornyn and Ted Cruz defied the will of Texans and ignored good fiscal sense by essentially making a public pledge to keep Texas' status as having the highest uninsured population in the United States. Democrats including Congressman Lloyd Doggett, Congressman Joaquin Castro, Mayor Julian Castro and several state legislators held their own press conference with budget experts, health professionals, local elected officials, and Medicaid recipients to make the case that Texas' citizens and the state budget would greatly benefit from the federal funds.
The offer on the table from the federal government is worth more than $100 billion to Texas over 10 years, with the state's portion incrementally increasing before being capped at 10%.
The math is simple and missing this opportunity adds up to more local taxes. If the state opts out of contributing to indigent care, the burden will merely be shifted to counties, charities and families already facing economic hardship. This case was made strongly by Dallas County Judge Clay Jenkins, saying it was, "unfair to local tax payers". Perry said Texas needed the, "flexibility to care for our own in a manner that makes sense both effectively and financially.", however as state Rep. Chris Turner (D-Arlington) said, "after 12 years of Governor Perry's health care policies, we have the highest rate of uninsured in the nation." Perry wants a block grant so he can take the money but still keep control over implementation and benefits. Judging by his call to drug test TANF recipients I'd hate to see what eligibility would look like under that regime.
Congressman Doggett called Governor's request for a block grant "blockheaded" and Congressman Castro said Perry needed "to lose the swagger and get serious." Both men cited Republican governors who have put partisan politics aside to help the uninsured in their state and asked the Governor to reconsider sitting down with the Obama Administration to workout a deal.
One Texas, the PAC founded by Rep. Trey Martinez Fischer (D-San Antonio), produced a great video of Republican Governors who have signed on the Medicaid expansion for the "moral" reason. During the press conference, TMF addressed the Governor, stating that "'no', is not a public policy," and suggested that the he should accept Medicaid in the spirit of Easter and Jesus' teachings, "feeding the hungry, healing the sick." He urged state leaders to act now and not to put off the most important business of the day saying, "manana" was the busiest day in the legislature.
Ted Cruz hoisted his Don't Tread On Me flag in full defiance of compromise saying he was proud of Texas as Republicans in other states were "giving in." The House budget debate will begin Thursday, but the House Republican Caucus, surely under a great deal of pressure from the Governor, has already voted to reject proposed Medicaid expansion, but left the possibility of negotiations with the federal government open.
Check out more pictures from the Perry press conference protesters via Progress Texas on Facebook.
Saying he was "recommitting" himself to following the teachings of Jesus Christ after a period of intense prayer over the weekend, Texas Governor Rick Perry announced at a press conference on Monday that he supports expanding Medicaid in Texas under the Affordable Care Act.
"It would be un-Christlike to punish one-and-a-half million sick, poor Texans because of politics," said Perry, flanked by members of the Boy Scouts and Texas megachurch pastors Robert Jeffress and John and Matthew Hagee on the South Steps of the Capitol. "Jesus wouldn't let scouts like Jimmy or Grandma Hagee go broke just because they got sick. Expanding Medicaid is the Christian thing to do."
Perry is the latest Republican governor who, after taking time to consider the issue, has decided to support the expansion of Medicaid provided in the Affordable Care Act. Though Perry's reversal came amid mounting pressure from Texas hospitals, business representatives, newspaper editorial boards, and even members of Perry's own party, the Governor made it clear on Monday morning their arguments made no direct impact on his decision to support Medicaid expansion.
"I really had some soul-searching to do," said Perry. "Anita gave me one of those 'What Would Jesus Do?' wristbands after we ate our Easter ham, and I spent the rest of the day consulting with Jesus. I know He would treat the 'least of these,' better than I have, and I'm recommitting myself to following his example."
On April 1, Governor Perry and Senators Cornyn and Cruz hosted a press conference and issued a joint 
On Monday Texas politicians redrew battlelines over the proposed Medicaid expansion in Texas. Governor Perry, and U.S. Senators John Cornyn and Ted Cruz defied the 
One Texas, the PAC founded by Rep. Trey Martinez Fischer (D-San Antonio), produced a great 
