Texas’ Perry rejects Medicaid expansion. What now? (+video)
Now that Texas Governor Rick Perry has rejected the federal expansion of the Medicaid program, health care providers in the state would like to see Perry's alternative health care plan. Others praised the governor's decision.
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Many had pinned their hopes on victory in the courts and now hope Republicans can sweep this fall’s elections and repeal the law.Skip to next paragraph
In Pictures Texas Gov. Rick Perry
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“We’re just not going to be a part of … socializing health care in the state of Texas,” Perry told Fox News.
Parkland Memorial Hospital, which treats many of the North Texas region’s uninsured patients in its emergency room, said Perry’sresistance to the proposed Medicaid expansion won’t stop the flow of indigents seeking care at safety-net hospitals.
“If our state is going to turn away hundreds of millions in federal funds, we are eager to see what our leaders will propose to replace them,” the Parkland Health & Hospital System said in a written statement. The system said that last year it provided $605 million in uncompensated care.
Dan Stultz, an internist who heads the Texas Hospital Association, said Medicaid offers only paltry payments to providers, but having uninsured people flock to emergency rooms for care simply shifts costs to those with insurance. It also places more burdens on the county property owners whose taxes support hospitals such as Parkland.
“With a strained state budget, it’s hard to imagine addressing the uninsured problem in Texas without leveraging federal funds, which will now go to other states that choose to expand their Medicaid program,” Stultz said.
Houston neonatologist Michael Speer, president of the Texas Medical Association, said he’s especially worried about uninsured adults under the poverty line, who were intended to be added to Medicaid and may not qualify for subsidies to buy private plans.
Legislators could attempt to buck Perry on the issue next year, though it’s unlikely enough other Republicans will want to do so.
Either way, Medicaid — one of the largest parts of the state budget — will again be a major issue. Last year, lawmakers helped bridge a $27 billion shortfall by underfunding Medicaid by between $4 billion and $5 billion of state funds. They’ll have to pay the tab in 2013, even though state finances are expected to again be tight.
Texas state Rep. Garnet Coleman, a Houston Democrat who is a leading health policy writer, said Perry “chose the policy that’s best for him politically” but ignored the plight of poor adults, many suffering from diabetes, cancer and mental illness.
“The governor said it’s better to follow his ideology and throw those folks under the bus than to provide health coverage that the state of Texas would pay zero for, at least for the first three years,” Coleman said.
Free-market advocates praised Perry. Merrill Matthews of the Dallas-based Institute for Policy Innovation said that “if enough states push back, maybe they can get the flexibility to try and actually fix the broken Medicaid system.”
Texas could aim to eventually negotiate a better deal, too. For the law to succeed, the administration needs to see the number of uninsured greatly reduced, and Texas has a higher rate of population without coverage than any other state.
States have tended to go along with past expansions of government coverage for the poor and near-poor, even if they first balked, federal officials noted.