A question in Texas has been whether to expand Medicaid or find a palatable alternative that accomplishes the same thing.
-If you have health insurance, your premium is $1,800 higher because of those who are without insurance.
-Bexar County pays $52 million to $58 million yearly for CareLink to provide indigent care.
-By refusing to expand Medicaid — or negotiate an alternative — Texas is rejecting 100 percent federal funding for three years for those who would be covered by expansion, with the state share capped at 10 percent after that. Texas tax dollars are going to other states.
-Expanding Medicaid — or an alternative with the same goals — can put a dent in the state’s nation-leading percentage of uninsured residents by covering an estimated 1.1 million Texans, who make up the 40 percent of the state’s uninsured.
Actually, the question of expanding Medicaid isn’t really on the floor as a practical matter. This simply isn’t viewed as an option by the Texas Legislature for a variety of perfectly unreasonable reasons.
So, as a matter of political reality, that leaves us with that palatable alternative. Hospital and medical interests — a gathering of which provided the above figures to this Editorial Board recently — are pushing the Texas Way, an alternative that will require those covered to pay a portion of their medical expenses and provide other incentives for more healthy living. Other states have negotiated such deals with the feds.
Texas’ political reality is that Medicaid, though a proven health care product for many of the state’s needy, is viewed as a reprehensible manifestation of an unsustainable nanny state by much of the Legislature.
We can disagree and still reach common ground as long as the state can get the same deal — meaning the same dollars.
Calling or making it something else won’t matter to those Texans who will be getting coverage. And if it is more market-based, these newly insured Texans won’t mind as long as it is affordable — as in co-pays and other out-of-pocket expenses that aren’t prohibitively expensive.
The goal should be getting uninsured Texans insured. That is the common ground that Democrats and Republicans in the Legislature should work toward.
A starting point? Agreement that Texas leading the nation in the percentage of uninsured residents — a substantial number of whom are the working poor — should make us ashamed.
Source: San Antonio Express-News