You know what they say about assumptions. And two specific assumptions in the Texas media’s chorus of condemnations of the Legislature for not expanding Medicaid stand out as both ill-informed and short-sighted—the assumption that expanding Medicaid would result in better health and fiscal outcomes, and that coverage equals care.
Both assumptions are made in a recent Austin American-Statesman editorial: “It is disgraceful that GOP leaders opposed to Medicaid expansion would rather deny those Texans coverage, and shun billions of dollars in federal aid, just to prop up our current system that parcels out health care to the poor as inefficiently and expensively as possible, at emergency rooms that can’t turn anyone away for inability to pay.”
Like so much of what’s wrong with the American health care system, the Statesman is reasonably close in its diagnosis—our current system is broken—but its prescription is about as helpful as a medieval barber recommending a good bloodletting.
The truth is that Medicaid is a deeply flawed system that fails to live up to its promises. It’s also true that Texas lawmakers did move health care forward in Texas—just not in the way the media wished.
Rather than expanding a poorly performing program, the Legislature focused in a bipartisan manner by improving Medicaid, by making prescriptions more affordable for the uninsured, by driving down the cost of services, and providing new options for the uninsured rather than the one-size-fits-all Medicaid.
Two bills improved Medicaid: House Bill 290 and House Bill 133. HB 290 strengthens the states’ Medicaid program for vulnerable children by streamlining the eligibility process and ensuring continuous coverage for up to a year past eligibility. HB 133 addresses maternal health and mortality by expanding Medicaid eligibility to new mothers for up to six months after their child’s birth.
House Bill 18 established a prescription drug savings program for uninsured Texans. Senate Bill 1137 strengthens hospital price transparency, a fundamental step toward making health care more affordable for all of us.
House Bills 3924 and 3752 allow certain member organizations—like The Farm Bureau and Texas Mutual—to create customized health benefit programs for individuals and families. These programs are an alternative to Obamacare, which has resulted in skyrocketing insurance premiums and high deductibles.
Together, these new laws help Texas families get what they need—care, not simply coverage. The fact is that adding 1.4 million people to the Medicaid rolls in Texas would swamp the system. A 2016 survey by the Texas Medical Association suggested that less than half of Texas doctors would be willing to accept new Medicaid patients, primarily because of low reimbursement rates and the bureaucratic burden that comes along with it. Expansion could greatly exacerbate this problem—and crowd out the state’s neediest families.
Texas families aren’t worried about scoring political points; they’re worried about the cost of health care. Fortunately, the Legislature listened to Texans, rather than the media’s incessant calls for Medicaid expansion. The result will be a healthier, more prosperous state.