AUSTIN (Nexstar) — Nearly 2 million Texans who currently fall into the Medicaid coverage gap could soon have better access to health care coverage if a Texas-based bill passes congress.
That gap refers to Texans who make too much money to qualify for full Medicaid coverage, but too little to qualify for subsidized coverage in the marketplace. Texas Congressman Lloyd Doggett (D-Austin) thinks he found a way to work around state barriers with the Cover Now Act.
“Let’s empower local governments to offer to their neighbors Medicaid expansion and do it on the same terms that applied to the state when it rejected this session after session,” Doggett said at a news conference Monday.
The Democratic representative said the bill will allow local entities to apply directly for federal funding that the state already qualifies for, but refuses to accept.
It would help people like Vanessa Vega, a grad student at Texas State University. She turns 26 in November, and will fall into the coverage gap when she gets kicked off of her parents’ health care plan.
“What am I supposed to do? Do I take out student loans and not pay for my school bills? Do I take out loans in order to pay for health coverage? Do I just go into debt through medical bills?,” Vega asked, explaining her assistant grad position income doesn’t qualify her for either the subsidies or Medicaid.
“The fact that me making $7,000 a year I’m can’t get subsidized health insurance. But somebody who makes 35,000 a year does. I mean, well, how can you even explain that?” Vega said.
Republicans have long opposed expansion. Texas Public Policy Foundation’s Right On Healthcare Intiative director David Balat explained the government should be addressing systemic flaws before adding more people to the system.
“They’re not increasing the number of physicians that are that are taking the Medicaid program. So they’re further straining that system that’s intended for people that are in a really vulnerable spot,” Balat said.
He also said there’s a large number of Texans who do qualify for coverage right now, but have not enrolled.
“We need to find out why they’re nearly 660,000 people that are eligible but not enrolled, I think understanding where they’re coming from and what their needs are,” Balat said.
Rep. Doggett acknowledged that the bill would only be a success with cooperation from the states.
“We need access, for example, to the state Medicaid rolls. And so in this bill, we provide an incentive to the state with additional Medicaid administrative expenses, additional money the state will get if the locality decides to use this program,” Doggett said.
“We also provide some disincentives if we have a state that tries to block the local leadership as happened, unfortunately, during the pandemic on several health measures, then the state would lose money,” Doggett said.
He added that if the city of Houston alone was able to offer coverage to its residents who fall into the coverage, that would account for one-fourth of the total in the gap.
Doggett hopes that if some local entities have success with expansion, it will eventually pressure state leaders to do the same.
“The idea is ultimately to get to state expansion,” Doggett explained.