AUSTIN (Nexstar) — State Rep. John Bucy, a Democrat representing Cedar Park, is vowing to continue to push Medicaid expansion legislation at the Capitol, even after the Biden administration agreed to extend Texas’ 1115 waiver.
Last Friday, the Biden administration stated it would allow the 10-year extension of the waiver to stay in place, which was originally signed by the Trump administration.
The waiver was meant as a temporary transitional program, to give states time to transition to an expanded Medicaid program under the Affordable Care Act in 2010.
The state still has not expanded, though, because in 2012, the U.S. Supreme Court ruled states could not be forced to expand Medicaid.
The waiver reimburses hospitals, in part, for caring for uninsured Texans who walk through their doors.
“This waiver helps poor, and underserved people who are dependent upon these financing mechanisms to have hospitals in their communities,” Donald Lee, president of the Texas Essential Healthcare Partnerships, said Wednesday.
“There’s 5 million people that either don’t have insurance, or don’t have enough insurance, so that when they go to the hospital, those costs get paid for,” Lee continued.
Biden revoked the waiver to try to force Texas Republicans to permanently expand Medicaid in Texas, although lawmakers still refused.
“These waivers do not deal with the coverage gap,” Rep. Bucy stated.
The coverage gap refers to the estimated 1.7 million Texans who are too poor to qualify for Affordable Care Act marketplace assistance, yet ineligible for Medicaid because they’re above the income threshold due to the state’s refusal to expand coverage.
“By getting Medicaid expansion, then people will have actual health care. And they can deal with preventative care, they can deal with annual checkups, instead of just going into an emergency room getting reimbursements and other kinds of the most extreme care,” Rep. Bucy explained.
Republicans, though, said that expansion could backfire, and take away from those already enrolled in the program.
“We’ve got to be cautious. By saying we’re going to expand a bunch of people coming in, your two-week wait for doctor’s appointments are going to be four. And sometimes you can’t wait four weeks,” State Rep. Jim Murphy, a Houston Republican, said Wednesday.
“There’s truly needy folks who are waiting for care on Medicaid are on. It’s called the Medicaid waiting lists. And so when you push a bunch of able-bodied adults into the program, you’re stealing dollars from the truly needy, so the disabled, and others who actually who truly need these, this health care, you’re stealing dollars from them to give to able-bodied adults,” Stewart Whitson, legal director for the Foundation for Government Accountability.
The foundation did an analysis on how expansion could impact Texas.
“If you expand Medicaid coverage to all Texans, based solely on income, then this is the numbers you’re looking at: It’ll cost the state of Texas $12.9 billion over the next decade, that cost doesn’t include what the federal government’s paying, that’s just what it’s going to cost Texas,” Whitson said.
“State legislatures don’t have an infinite amount of money to spend. And there’s a lot of worthwhile programs, there’s public safety, there’s education, there’s health care, and there’s a ton of other important issues,” Whitson continued.
There’s also concern from Republicans the federal government would walk back how much they’re willing to pay for the coverage, which would leave the state footing more of the bill in the future.
“This is a nine to one federal match, and we pay the taxes for this already. So we’re not asking for more money, we’re talking about money you already pay as taxpayers to the federal government, let’s bring those dollars home and help Texans,” Bucy noted.
Rep. Murphy said the Biden administration’s move last year, revoking the waiver in the first place, did not help move the needle for Republicans.
“You go, wait a second, is our the health care of Texans gonna be subject to the whims of some administration? Hopefully not, but we need to work through that,” Murphy stated.
Bucy pointed to other states that have expanded for a bid of confidence, though.
“We’ve got a 10-year track record of other states that have done this, where the government hasn’t changed the plan or the policy,” Bucy explained.
Bucy also added Democrats have suggested bills for expansion that would include language to bring lawmakers back to the drawing board if the federal government did adjust how much they were willing to pay.
“We proposed bills that would do that. And we’ve told our colleagues across the aisle that we’d be willing to take that vote because we know that this is better for Texans,” he said.
Murphy said the state is slowly working toward its own plan to get the uninsured covered.
“We extended maternal care this past session, so that moms would have care when their babies are born. So we’re trying to find those things we can all get behind. And it’s just a multifaceted, it’s like three-level chess, it’s it’s not an easy process, but we’re getting there,” Murphy said.