Why Is Texas ‘Really’ Not Expanding the Medicaid Program?

By Juan H. Flores, NewsTaco

Texas legislators are holding firm in their decision not to accept the 66 billion in federal dollars available under the Affordable Care Act (ACA) to expand the Medicaid program.   Contrary to popular belief the issue is not about whether or not to expand Medicaid health insurance coverage for uninsured poor adults.

The hidden debate is about certain beliefs and power. Do most state legislators, Lt. Governor and Governor believe that:

• Everyone should have equal access to health care regardless of income?
• The ACA or ‘Obama-Care’s Medicaid expansion is too costly and will destroy our health care system?
• Texas should address and control any changes to our state’s health care system, and not big federal government?
• Expanding Medicaid will contribute to more dependency, particularly among the poor and people of color?
• The state’s health care market must be free to work its competitive magic, as healthcare is just another product from which consumers can buy what they can afford?

It appears our policy makers believe the negative views about Obama-Care, namely, that Medicaid fosters more dependency, and that the free-market is central to solving the state’s healthcare access problems, i.e., assuming they think any exists.

Medicaid supporters are trying to sway the policy-makers to accept the expansion funds.  Hospitals, business chambers, health professionals, local public officials, and faith-based and grass-root groups from across the state support the expansion.   These groups have documented support regarding Medicaid’s health and economic benefits for uninsured families and the state own prosperity. Whereas, our policy-makers decision is standing on beliefs which are largely unsupported, and often referred to as ‘my principles’.

Certainly, one has a right to individual beliefs and principles.  However, when your decisions negatively affect the health and financial security of thousands of families; is it FAIR or even ETHICAL?  Already, over 1 million low to middle-income Texans have acquired health insurance through the ACA Federally-based Health Insurance Exchange.  Texas could have, but did not want to implement the Health Insurance Exchange.

To their credit, Representative Coleman Garnett from Houston and Senator Jose Rodriquez from El Paso proposed legislation that identified a ‘Texas Way’ to provide health insurance coverage.  Their legislative bills shied-away from calling it Medicaid expansion and also emphasized personal responsibility and market-based language.

Sadly, even their watered-down language-acceptable bill failed to sway Medicaid expansion opponents as evident by the lack of serious legislative consideration. In fact, over the past 30 years, Texas politicians have engaged in a shameful dance of ineffective legislation that has kept millions of our citizens uninsured.

As a result, nearly 1million of our citizens who don’t qualify for the Health Insurance Exchange but would qualify under the Medicaid expansion will remain uninsured.  Billions of our tax dollars will go to other states, and Texas families will continue to experience poor health, unnecessary suffering, even death, and financial insecurity.  Furthermore, local tax payers should be aware that this legislative inaction continues to burden us with billions for uncompensated health care costs; plus billions from lost worker productivity.

Our legislature can approve a one-paragraph bill to accept the ACA’s Medicaid expansion funds, and our Governor can sign-it.  So easy, yet political ideology masking as supported principles, and uncompromising use of party-power trumps health care equality for all Texas citizens. We Texans must insist that our legislatures recognize that the time is now to set aside personal views, and stop stigmatizing ‘Medicaid’.  Access to affordable healthcare must not be a privilege for the few but a right for all our brothers and sisters.

Indeed, in the eyes of the current legislative power-brokers it seems that Medicaid and the families it serves are ‘bad’ for Texas.  Our state will lose the approximate $66 billion dollars, and over $34 billion in hospital reimbursements.  Yet, for every $1 the state invests in Medicaid expansion, $13.41 in federal funds will flow into the state.

On this issue, the Texas Way is the Wrong Way.

Juan H. Flores is a consultant and advisor for the La Fe Policy Research and Education Center.