HOUSTON -- Many of the state’s elected officials – including Gov. Rick Perry and a number of state legislators – refuse to expand Medicaid under the Affordable Care Act (ACA), despite Texas having the largest proportion of uninsured citizens in the nation.
According to experts who spoke during an ethnic media roundtable discussion in Houston, fully implementing the ACA is the right thing to do. The roundtable was organized by New America Media.
“Expanding Medicaid will save lives,” said Charhonda Cox, executive director for Texans Together. “Everybody pays less when more people have insurance. Costs go down and quality of care goes up.”
The expansion, which is one component of the larger ACA, is set to take effect in January 2014 and would guarantee coverage for families earning at or below 133 percent of the federal poverty level.
Currently, there are about a quarter of Texans (6.2 million people) are uninsured. With the expansion in place that number is projected to drop down to just under 12 percent.
In addition to more healthcare coverage for adults and children, the expansion would also bring in billions of dollars in federal funds to the state.
For the first three years, the federal government would cover 100 percent of the costs. By the fourth year, states that choose to keep the expansion would pay a percentage of it out of their own budgets.
“This is a great financial deal,” said Laura Guerra-Cardua, Texas associate director for the Children’s Defense Fund. “Over the next 10 years, we would have to put in $15 billion to get $90 billion back. This is money infused back into our communities, creates tens of thousands of jobs and could really benefit everyone.”
Still, there are opponents who argue that expanding coverage would cost the state too much, especially long term.
Eva DeLuna Castro, senior budget analyst for the Center for Public Policy Priorities in Austin, said many legislators fear that Texas would get stuck paying for the program well after the initial free years.
“It doesn’t make sense to refuse to do a good thing now because 10 years down the road it might present a challenge,” she said. “At least for 10 years we had something good happening for our children and our adults.”
Moreover, Guerra-Cardua said taxpayers would end up paying for Medicaid costs regardless of whether Texas accepts the expansion.
“People who are uninsured still get sick,” she said. “But the difference is, they usually wait to go to the doctor and when they show up, they are much more sick…and they go to the emergency room, which is far more expensive than a doctor’s visit.
“When costs are not covered by these families, they are passed on to local taxes,” she said. “And we pay for them without the opportunity to get federal tax dollars back to help pay for that care.”
Cox said with the legislative session ending in May, there is not much time left to change the minds of legislators who refuse to accept the expansion.
“We want to make sure the folks we put in office have pressure to vote yes,” she said. “The only way they’ll do that is if they know that the people who can vote for them again want this to happen.”
This story was written as part of a series of press briefings on healthcare reform with ethnic media organized by New America Media and funded by the Atlantic Philanthropies.