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Dewhurst, Nelson Support Healthcare Reform, not Medicaid Expansion

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Lt. Gov. Dewhurst and Sen. Jane Nelson (R-Flower Mound) at Wednesday's press conference discuss SB 7 and 8.
Beth Cortez-Neavel
Lt. Gov. Dewhurst and Sen. Jane Nelson (R-Flower Mound) at Wednesday’s press conference discuss SB 7 and 8.

Lt. Gov. David Dewhurst told reporters at a Wednesday morning press conference that he has no plans to put Medicaid expansion on the legislative table.

“We carefully cover, under Medicaid, those populations we feel need care,” he said. Dewhurst made clear that Texas should exclude from Medicaid adults who are “able-bodied, who could go out and work”

Texas’ uninsured population is the highest in the country, a quarter of the state’s population lacks health insurance.

If Texas doesn’t consider the federal offer to largely pay for a Medicaid expansion, Texas would turn away billions in federal dollars to cover uninsured citizens who live 133 percent above the poverty level and under. An estimated 1.5 million Texans would gain health insurance from Medicaid expansion.

Quite a few Republican governors—including our own—have rejected the expansion, a few have accepted it. In fact, Arizona’s Republican Gov. Jan Brewer, who has previously wagged her finger at Obama and his administration, said in the State of the State address on Monday that she is planning to push for Medicaid expansion in her state. It was too good a deal to pass up.

At the press conference, Dewhurst and Sen. Jane Nelson (R-Flower Mound) also discussed their plans to expand on last session’s healthcare changes with even more “free-market reforms,” Dewhurst said.

According to the Office of the Inspector General, more than $6 billion was lost between 2004 and 2011 to “fraud and waste” in the Health and Human Services Commission through Medicaid/CHIP programs and Managed Care Organizations. This is the first problem Nelson wants to tackle.

“When you defraud the system you are stealing from the taxpayers, from the children, from the poor, the elderly and Texans with disabilities,” Nelson said. “It is a crime against our most vulnerable citizens and we have to change our approach to stopping it.”

Currently, fraud is being caught weeks or months after the services are provided, and Nelson’s Senate Bill 8 would create a new program that Nelson hopes will focus more attention on false claims earlier in the process, before the damage adds up a steeply as it has in the past.

Among a few other things, SB 8 will ban healthcare providers from participating in Medicaid if they have committed fraud. The bill also disallows personal solicitation of clients through any kind of marketing – which Dewhurst helped clarify as including “Providers with vans going around trying to pick up children and take them for different services.”

SB 7 looks to build upon some Medicaid services. This bill would re-design the healthcare system to provide more “cost-efficient” and “appropriate” services to senior citizens and Texans with developmental and intellectual disabilities, after assessing for them what those needs are. Nelson said the problem now is that we have a few seniors and Texans with disabilities that have access to a large array of unused and unnecessary services. Meanwhile, there are countless other individuals who are in dire need of these services and are “waiting months, or even years, for very limited, basic services,” Nelson said.The goal is to reach more individuals in need and “help them live independently rather than more costly.” Yet Dewhurst, Nelson and other Texas Republicans refuse to support the Medicaid expansion.