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Working the county Medicaid expansion angle

As statewide Medicaid expansion is being pushed in Austin, some activists are going to various County Commissioners Courts to push for the county option to expand Medicaid as well.

“A broad spectrum of people across business, faith and health care communities are coming together to ask that we find a way to draw down these federal dollars, and I think it’s imperative that we do,” said Judge Clay Lewis Jenkins, chairman of the Dallas County Commissioners Court.

In 2011, local Texas governments, cities and counties, spent $2.5 billion in unreimbursed health care costs, according to a report by Billy Hamilton, the state’s former deputy comptroller and former chief revenue estimator. If Texas expanded Medicaid coverage to impoverished adults in 2014 under the Affordable Care Act, the state could receive an additional $100 billion in federal dollars over 10 years, helping to offset that spending by local governments. The state would pay $15 billion during that time, which opponents of the expansion, including state Republican leaders, argue is too much.

“We’re doing his across the state. The resolution is our strategy…to put pressure on the governor and the Legislature to pass Medicaid expansion,” said Willie Bennett, lead organizer with the Dallas Area interfaith coalition, which helped write the resolution on Medicaid expansion that Dallas County plans to adopt on Tuesday. He said their organization helped craft a similar resolution that the El Paso County Commissioners Court adopted on Monday, and is working with other major counties to also pass resolutions.

[…]

“Working uninsured [Texans] are leading the fight. These are everyday people who work, some of them six days a week, but can’t afford health insurance,” said Durrel Douglas, a spokesman for the Texas Organizing Project.

Dallas County could get $580 million in federal revenue to help insure 133,000 additional residents through the Medicaid expansion, Jenkins said. (Use this Tribune interactive to compare the costs and savings of expanding Medicaid.)

“What it boils down to is, if we don’t take it, our federal tax dollars will pay to cover this population everywhere else in the country and our local tax dollars will pay to cover it here,” Jenkins said. “That puts us at a health care disadvantage, because we have the nation’s highest uninsured rate already, and it puts us at a competitive disadvantage because you’re paying federal taxes to cover everybody else, but you’re not getting your fair share.”

I’m still not certain that the county option is allowable under Medicaid rules, but I applaud the Texas Organizing Project for their initiative. The more sources of pressure that exist for expanding Medicaid, and the more voices calling for it, the better. They got what they wanted in Dallas County.

Dallas County commissioners endorsed an expanded Medicaid program Tuesday that would cover uninsured low-income residents who otherwise must rely on charity care or county tax dollars to cover their medical costs.

County Judge Clay Jenkins said the 4-0 vote was not a political ploy directed at Gov. Rick Perry and other Republicans, who have staunchly opposed expanding the state-federal program.
“I hear Governor Perry saying Medicaid is a system in need of reform, and I agree,” Jenkins said. “Let’s find a way to craft a Texas plan that reflects the values of the state’s elected leadership and brings those much-needed dollars here.”

[…]

Locally, the expansion would funnel an estimated $580 million to Dallas County to cover new Medicaid recipients in 2014. The money would lessen the burden on local health care providers now treating such uninsured patients, usually in their emergency rooms.

“Parkland Hospital has estimated that the expansion will cover 133,000 Dallas County residents, whether they are going to Baylor’s ER for care or to Parkland’s community clinics,” Jenkins said. “This is the math, and it makes sense.”

[…]

The Dallas County vote won praise from the medical community.

Dr. Sue Bornstein, a former board member of the Dallas County Medical Society, said the current Medicaid system needs fixing as well as expansion.

“I’m certainly pleased that the county judge came out with this,” she said. “It’s our tax money, too. And in Texas we don’t want our tax money going someplace else.”

That’s the argument that has swayed an increasing number of Republican governors to accept Medicaid expansion, but as we know Rick Perry is more resistant to facts and reality than most. The TOP is working on similar resolutions in other counties – via email, Durrel Douglas told me that Bexar County, whose officials were the originators of the county expansion idea, is slated to vote on theirs in two weeks, and they are working to bring them to Harris, Hidalgo, El Paso, and hopefully others as well. I wish them the very best of luck. ThinkProgress has more.

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5 Comments

  1. jpt51 says:

    Looks like the strategy may be working… For the sake of the poor, let alone hospitals and nursing homes, I hope the expansion happens.

  2. […] not be on the table for the state right now, but there’s no reason Harris County can’t join with Dallas and other counties to formally request the right to do its own expansion. I’d conservatively […]

  3. […] no one has gotten rich underestimating Perry’s fanaticism lately. Still, bringing pressure from the county level is the smart move, though it would really help if Harris County would get into the game. If we […]

  4. […] this has been cleared up. Now I hope that Commissioners Court follows the Judge’s lead and passes a resolution calling on the Lege to do its […]

  5. Bill Shirley says:

    I’ve said this before! Harris County has to have more population than many states, we should be able to bypass Perry and directly deal with the Federal government. More local is better, right?

    I’m glad they’re using those government satellites to read by brain for Good and not Evil.

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