Can common sense trump partisan politics? The question is especially apropos these days in Texas, which accounts for about 25 percent of the 4 million Americans who would gain health insurance if their state’s lawmakers expanded Medicaid.
The healthcare industry knows how unlikely that is to happen in the Lone Star State, where the Legislature will reconvene this month for its 84th session. Republicans rolled again in the midterms, leaving Democrats just 63 seats in the House and Senate compared to the GOP’s 118. Instead of giving up, though, healthcare providers are promoting workarounds to address the worst uninsured rate in the country without expanding Medicaid.
According to the most recent Census stats, nearly 6 million non-elderly Texans lack health insurance. About half of those are eligible for coverage in the Affordable Care Act’s exchange markets, according to estimates from the Kaiser Family Foundation. During the first open enrollment period, about 734,000 Texans registered for a plan. But then there are the estimated 1.05 million Texans who fall into the so-called coverage gap.
This group of working poor makes too much to be enrolled in Medicaid, but not enough to qualify for federal subsidies on the exchanges. The Obama administration is dangling $90 billion over the Legislature to be doled out over the next decade to insure this group of residents.
Expanding the program for 10 years, a tenet of President Obama’s healthcare reform law, means the feds pick up 100 percent of the costs through 2016 and 90 percent each year thereafter. Estimates say Texas would contribute no more than $15 billion.
But to many legislators, a vote for Medicaid expansion is a vote endorsing Obamacare. So, the politics have soured its potential to help improve the state’s bottom-of-the-barrel uninsured rate of 22.1 percent, as reported in the most recent U.S. Census figures from 2013.