Two years ago the Texas Legislature, cowed by veto threats from Gov. Rick Perry, turned down billions of dollars in health care funding from the federal government.
It was sacrificed on the altar of politics — that is, the desire to do anything possible to make the Affordable Care Act a failure — without much regard to what it would do to typical Texans or Texas hospitals.
Today, we see the results right before us: hospitals having to cut back or shut down and rural residents being forced to find new, out-of-town (or out-of-county) resources for basic care and even emergency medical service. Many of those hit are elderly or poor and, for some of them, the cutbacks simply mean doing without. And Texas continues to have the highest rate of uninsured people in the nation.
All because of politics.
Texas heath care, particularly in rural areas, is a mess that’s getting worse with each passing month. The only prospect for improvement is our Legislature acting responsibly and putting aside the politics.
Unfortunately, given the makeup of our top office-holders and Legislature overall, the prospects for ignoring politics for the common good don’t look promising.
The solution does not have to be to move in lockstep with Obamacare. Other states have developed their own plans that work with the federal legislation. However, Perry made it clear he would have none of that, though a number of Republicans in the last session said they were open to the attempt.
This session, those plans should be resurrected and pushed forward to bring home the billions of dollars Texas is due. Lawmakers also should take a look at proposals recently forwarded by the Texas Hospital Association and the Texas Medical Association for new approaches to insuring the working poor. Even an advisory group appointed by Perry, the Texas Institute of Health Care Quality and Efficiency, has put forth plans to begin cleaning up the mess.
Gov.-elect Greg Abbott could help by announcing upfront he will be open to a Texas plan. That could get the wheels moving, though it would not mean such a plan will be approved. There is still, incredibly, heavy opposition. But we know there’s some support. More importantly, we know there’s a huge need across Texas that lawmakers must begin to meet.
Not accepting the federal money will only continue to put pressure on health care providers and on Texans. Rural health care especially will only face more challenges in the coming two years.
Fixing this should be a priority for this Legislature.
Other areas of health care law that need attention include:
Finding other ways the state can assist in bringing health care to rural areas. These need not be permanent facilities but rural Texans have lost much in the past two years and some of it needs to flow back.
Increasing funding for graduate medical education. The cost of such education is daunting for most prospective doctors and relief is needed. This could be tied to a program requiring individuals to begin their practices in rural areas.