Melissa del Bosque

The Clock is Ticking for Texas on Medicaid Expansion



Back in 2010 Governor Rick Perry compared the passage of the Affordable Care Act—aka Obamacare— to something like Godzilla crushing the Statue of Liberty. “Freedom was frontally attacked by passage of this monstrosity,” he huffed.

In three years, Perry’s rhetoric hasn’t changed much on health care reform despite lobbying from thousands of Texans, local government leaders and the medical community. On Tuesday, an estimated 2,000 Medicaid recipients and supporters gathered outside the Texas Capitol to persuade Perry and other Republicans to get behind the Medicaid expansion.

As lawmakers met inside the Capitol, former Texas Medicaid director DeAnn Friedholm addressed the crowd from the south steps, chiding Perry and legislators who have steadfastly rejected the expansion. Accepting the Medicaid expansion could provide the state with $100 billion in federal money the first decade, and provide insurance for at least 1.5 million Texans. “We’re here because people in the Capitol either don’t understand or even worse they understand but don’t care,” she said. “And we need to make it absolutely unacceptable, morally and politically, for them to do nothing.”

Friedholm, now the director of health reform for the advocacy group Consumers Union, said legislators should not get sidetracked by the argument that Medicaid is broken. “Can it be better? Yes!” she said emphatically. “But the biggest problem for Medicaid right now are the payments which are so far behind that doctors won’t accept Medicaid. And it’s the Texas Legislature that’s in charge of setting Medicaid rates.”

Texas Rally for Medicaid ExpansionIt’s rare that the business community, local government and powerful healthcare groups like the Texas Hospital Association and Texas Medical Association come together on an issue, she said. “The last time that happened was 10 years ago, and we passed CHIP [the Children’s Health Insurance Program] which is a pretty great program.”

People came from all over the state for Tuesday’s rally. Mike Seifert, a community coordinator with the grassroots RGV Equal Voice Network said 107 people from the Rio Grande Valley got up at 3:30 a.m. to board two buses for Austin. “It’s not easy when you’ve got kids and jobs, but they wanted to be here,” he said.

Seifert said Medicaid expansion could transform things for people along the Texas-Mexico border who “live day-in and day-out with the anguish of not having health insurance.” Many uninsured residents used to go to Mexico for low-cost health care, but are now unable to go because of the violence, he said. “I know of a woman who used to see a dentist in Mexico but she can’t go anymore. She had to pull out her own tooth because she didn’t have insurance.”

At the rally, Courtney Wyrtzen, from Austin, held up a photo of her 11-year-old daughter Blythe, who suffers from a nervous system disorder called Rett Syndrome. Wyrtzen said her family relies on Medicaid’s Medically Dependent Children Program for the treatments her daughter needs. “Children with special needs are receiving life saving care from Medicaid,” she said. “We need to protect it.”  Courtney Wyrtzen

Perry isn’t yielding on the Medicaid expansion. But at least there seems to be discussion among Republicans on how to lift Texas out of its dismal role as the state with the highest number of uninsured in the nation. Some legislators are reportedly    looking at a waiver recently granted to Arkansas that would allow newly eligible Medicaid recipients to move into a state health insurance exchange. The federal matching funds for Medicaid would be provided as a subsidy to taxpayers.

The clock is ticking. The federal government will only provide its generous 100 percent match (later shrinking to 90 percent) through 2016. It’s late in the game for Texas to draft an entirely new waiver application and program, and Perry already rejected setting up a state exchange like the one Arkansas will use.

We could know a whole lot more about where Texas is heading later this week. House Appropriations Jim Pitts (R-Waxahachie) announced today that his committee will discuss Medicaid expansion Friday.