Medicaid drew massive rallies, little action at Texas Capitol this session

AUSTIN -- Of all the issues on the march at the Texas Capitol this session, few matched the numbers and volume of demonstrations demanding Texas expand Medicaid. Groups representing business interests, the medical profession and religious branches, as well as activist organizations and unions, all took turns demonstrating both together and separately.

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"I have sickle cell, and last year I almost died of my sickle cell crisis, "Houston mother Latoya White told KVUE at a March 5 rally which saw hundreds marching down Austin's Congress Avenue. "I have three children. If I die, where are my kids going to be?"?

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At a cost to the state of roughly $15 billion over the next 10 years, expanding Medicaid as outlined under the Affordable Care Act (ACA) would secure an estimated $100 million in federal funds for Texas. The expansion would cover more than a million low-income Texans who can't afford private coverage by raising the current cutoff for Medicaid, a system Gov. Rick Perry has argued is broken.?

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"We would be foolish to continue onto a path that will bankrupt this country and that will bankrupt our states," Perry told reporters during an April 1 media conference inside his Texas Capitol office which was nearly drowned out by angry protesters just outside the door.

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"The problem is that the federal government, either they don't think we're smart enough or they don't trust us," said Perry, who has consistently advocated instead for a block grant from the federal government which would enable Texas to craft its own strategy for addressing the highest rate of uninsured citizens in all 50 states.

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"My plan increases the pool, it gives flexibility and it gives health care access to those folks," physician and state Sen. Bob Deuell (R-Greenville) told KVUE in March. One of a handful of Republican lawmakers who attempted to find a solution to lower the state's uninsured rate without alienating conservatives concerned with the appearance of aiding the ACA's implementation, his plan aimed to incorporate the state health care exchange and non-insurance options such as health savings accounts.

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Despite the efforts of Deuell and others, the 83rd Texas Legislature ultimately decided to do nothing on the issue of expanding health care access. As state lawmakers returned to the Capitol last week in a special session called by the governor to address redistricting maps, eleven Texas Democrats in the U.S. Congress signed a letter asking Perry to add expanding Medicaid to the call.

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"Among those Texans who are most affected by the failure to expand Medicaid insurance coverage are almost 50,000 Texas veterans," Doggett told KVUE Monday. "Our letter was timed with Memorial Day and our honoring our veterans to say let's honor them also by providing them access to health insurance."?

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"Texas will lose out on billions of dollars that it should be getting, that its taxpayers have contributed to finance," said Doggett. "Texas will be one of the few states that does not get the federal money that was appropriated to try to eliminate our distinction in Texas of having a greater proportion who are uninsured than most any other state."

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In response to the letter, a spokesperson from the governor's office issued the statement, "Gov. Perry and a majority of the Texas Legislature have sent the very clear message that they do not support expanding Medicaid under Obamacare."?

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So what does it all mean for patients and providers?

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"I think it is a huge missed opportunity, and certainly it's a fiscal impact for providers because we're already taking payment cuts under the Affordable Care Act. The coverage expansion was meant to help offset those payment cuts," said John Hawkins with the Texas Hospital Association. "It's a clinical impact as well. Folks won't have access to health care, that creates a cost shift to the private market and to local taxpayers in the county."

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"I think the hope is as we continue to visit this issue more, as we see other states look for innovative models to do alternatives to Medicaid expansion, that Texas will somehow administratively look at following suit," explained Hawkins. "I think it's still too early. The session's just been over for a week. I think it's going to be important to see what other states do, how far their conversations go with the federal government."

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At the Texas Health and Human Services Commission, ongoing efforts to secure outcome-based federal Medicaid Transformation Waivers have begun to pay off. Twenty regional health partnerships have submitted project proposals aimed to reduce local providers' reliance on Medicaid reimbursements through proactive measures such as open more minor emergency clinics. So far, about $3.2 billion has been awarded to participants.

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Meanwhile state officials negotiating a compromise with the Obama Administration must still answer to the governor, and a rider attached to a key piece of legislation in the waning days of the regular session requires any plan to be approved by the Texas Legislature as well. Meanwhile, hospitals and patients continue to hope a political cure can be found.?

Source: http://www.kvue.com/news/politics/Medicaid-drew-massive-rallies-little-action-at-Texas-Capitol-this-session-210154701.html

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