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Businesses say they want Medicaid expansion, too

This really comes down to two things.

It’s constitutional – deal with it

Chambers of commerce representing companies such as Exxon Mobil Corp. (XOM) and Kimberly-Clark Corp. (KMB) are challenging Texas Governor Rick Perry and lawmakers to expand health care for the poor in the state with the highest percentage of uninsured people.

The chambers of five cities are sending lobbyists to press Republican leaders to increase Medicaid coverage under President Barack Obama’s health-care law.

Businesses are often allied with Perry, a failed contender for last year’s Republican presidential nomination. The chambers, however, argue Texas shouldn’t pass up $100 billion over the next decade to cover 1.5 million adults. Obama’s plan would pay all costs until 2016, then the state’s share would gradually increase to 10 percent in 2020. Perry says that’s too expensive.

“This may be the only time that we have taken an actual formal position that is opposite that of the governor,” said Richard Dayoub, chief executive officer of the El Paso Chamber of Commerce. “I don’t know of any issue that has created so much concern across the state and has amassed so much support across party lines and throughout the business sector.”

Chambers supporting expansion in Dallas, San Antonio, Fort Worth and Arlington include members ranging from publicly traded companies to small shoe stores and family restaurants, many of them strained by health costs.

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About 29 percent of Texas citizens lack insurance, according to a March 8 poll by Gallup Inc. The state ranked 40th in health last year because 30 percent of residents are obese and one of every four children lives in poverty, according to United Health Foundation, affiliated with UnitedHealth Group Inc. (UNH)

Hospitals have urged expansion because it will reduce expensive and ineffective emergency-room visits, said Stephen Mansfield, chief executive of Methodist Health System in Dallas and next year’s chairman of the 2,100-member Dallas Regional Chamber.

“The eight other Republican governors were just as opposed to this initially as Rick Perry,” said Mansfield, who met with him in February. “They came to understand the economics.”

Chamber lobbyists from Dallas, Fort Worth and San Antonio have discussed Medicaid with legislators during the current session in Austin, officials said. Dayoub of the El Paso chamber spoke with Lieutenant Governor David Dewhurst and House Speaker Joe Straus, both Republicans, and about 35 legislators of both parties.

As a reminder, Progress Texas‘ list of all the groups that have endorsed Medicaid expansion is here. I keep harping on this theme, but it all comes down to whether any elected official feels like they might lose support for their position, and I just don’t see the evidence for that. Chambers of commerce don’t necessarily speak for their member businesses, as anyone who has followed the exploits of the increasingly hard-right US Chamber of Commerce can attest, so it’s not clear how much pressure they could apply to the likes of Rick Perry or Greg Abbott if the wanted to. Maybe they can put some heat on certain individual legislators, but I’m not holding my breath for that, either. People are going to have to lose elections over this, and that’s much easier said than done right now.

Business groups “are looking short term,” said Republican Senator David Duell (sic), a Greenville physician who met with chamber representatives. He said he doubted the Obama administration’s commitment “with the long-term viability of the federal government in question.”

Such opposition is “idiocy,” said Margaret Jordan, a former Federal Reserve Bank of Dallas director who is president of Dallas Medical Resources, a consortium of hospital executives and businesspeople headed by billionaire oilman Ray Hunt. “Medicaid expansion is a win-win for everybody.”

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The tension is evident 330 miles (531 kilometers) west of Dallas in Lubbock, a wind-swept city of 230,000 that is the hometown of 1950s rock ’n’ roll pioneer Buddy Holly and Texas Tech University. Medicaid divides the chamber of commerce, which favors expansion, and Republican Senator Robert Duncan, a lawyer who has served in the legislature since 1989.

After officials at the city’s UMC Health System explained how Medicaid expansion could cushion cost increases, chamber directors unanimously approved a resolution, said Chairman Carlos Morales.

“It’s a lot of money we’d be missing out on,” said Morales, who is executive vice president of Caprock Home Health Services Inc., a company that employs 2,200 in 12 Texas offices.

Duncan, however, says Texas can’t afford the deal because Medicaid crowds out spending for education, parks and other priorities.

“It’s not a free lunch,” Duncan said. He said he was unconvinced by studies by former deputy State Comptroller Billy Hamilton and Waco economist Ray Perryman suggesting expansion would boost the state’s economy by increasing business activity and productivity.

So on the one hand, you have people like Sen. Bob Deuell, who thinks we’re going bankrupt despite trillions having already been cut from the deficit, Medicare costs trending downward, and the entire basis of our medium-term debt-to-GDP ratio being a function of a temporary glut of old people. On the other hand, you have Sen. Robert Duncan, who doesn’t care what a bunch of high-falutin’ economists think when he just knows in his gut that spending money can only be a zero-sum game. Yeah, good luck changing that dynamic. In the meantime, the fanatics at TPPF present their never-gonna-happen case for Medicaid block grants so they can more efficiently deny access to health care to all those shiftless poor people, and the Democratic Congressional delegation chides Rick Perry for his continued mulishness on this topic. EoW and BOR have more.

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