What’s the biggest obstacle to drawing billions of federal dollars for the medically uninsured in Texas? Think of those politically radioactive terms Obamacare andMedicaid.
Some Texas Republicans have based careers on gnashing their teeth at the very mention. They depict themselves as anti-Washington warriors defending Lone Star principles of self-reliance. They vow to battle provisions of the president’s signature health care legislation, such as expansion of Medicaid coverage to the working poor.
Against this political reality, groups with a major stake in financing Texas health care — doctors and hospitals, among others — have fashioned pitches to next year’s Legislature related to that federal money. The talking points are free of hot-button terms. Instead, they hope for “access to care” for 1 million uninsured workers through novel approaches that might include accountability for newly insured Texans.
The goal is a familiar one and an important one: The state is leaving $6 billion in federal health care dollars on the table every year, and elected leaders in Austin should bring it home.
Amen to that. If it takes neutering the political language to get there, so be it.
In recent days, the Texas Hospital Association and the Texas Medical Association, the physicians group, have called for new, Texas-style approaches to insuring the working poor. So has an advisory group appointed by Gov. Rick Perry, the Texas Institute of Health Care Quality and Efficiency, a 15-member panel of providers and executives. They join chambers of commerce, the Texas Association of Business and the Dallas Citizens Council in advocating for federal money.
Lawmakers who lack a sense of urgency might ask Dallas County homeowners for a look at a property tax bill from the county hospital district. It’s no minor tax bite for residents and businesses, owing to the care that Parkland Memorial Hospital is obligated to provide uninsured people.
The Parkland system reported nearly $1.5 billion in uncompensated care last year. Who backfills that cost? Not the federal government, because state leaders won’t play ball. That means property owners get stuck with the tab.
Insured Texans also subsidize uncompensated care through higher insurance premiums. The hospital association estimates that the average family medical policy is inflated by $1,800 a year to offset the cost of the uninsured.
Lawmakers need to hammer out a more straightforward funding method than this passive scheme of spreading the pain. The GOP-controlled Legislature will find lots to work with in the proposals advanced by health care groups. The themes include buying coverage in the insurance market, asking recipients to share in the cost and requiring them to maintain health savings accounts.
By design, these approaches are tailor-made for the Legislature’s conservative drift. There will be many new faces when lawmakers convene in January. Let’s hope that means an honest attempt at solving one of the most politically delicate big-money issues that will be on the table in Austin.