In a surprise turn in the House on Monday evening, a bill to reform Medicaid long-term and acute care services became a vehicle for the GOP’s platform against Medicaid expansion.
“Many of us are very weary of Medicaid expansion,” said state Rep. Jeff Leach, R-Plano, who offered an amendment to Senate Bill 7 that would ban Texas from expanding Medicaid eligibility without the approval of the Legislature. While House lawmakers recognize that Texas’ large number of uninsured residents is a problem, Leach said, “We don’t believe that Obamacare is the answer to that.”
Leach’s amendment — which was adopted with a vote of 87 to 57 — would prohibit the Health and Human Services Commission from providing “medical assistance to any person who would not have been eligible for that assistance and for whom federal matching funds were not available” under the state’s existing criteria for medical assistance.
State Rep. John Zerwas, R-Richmond, expressed concern that the “broad stroke” of Leach’s amendment would handicap the state’s ability to stretch federal matching dollars in other programs, such as the 1115 Medicaid waiver program.
“I’m the first to tell you that the Medicaid system is very fragile,” said Zerwas, who has pushed this session for the Legislature to weigh in on the Medicaid expansion debate by approving “a Texas alternative” based on private-market reforms. “But this particular provision, in terms of restricting any ability to utilize matching funds for the provision of health care, is not the right amendment for this bill,” he said.
But under current law, Leach said, the state health commissioner or governor could expand Medicaid coverage without legislative approval. The expansion of Medicaid eligibility is “too big of a decision for the future of this state to be made by one person, and I believe the Legislature ought to be involved,” he said.
It’s hard to say that this makes much difference. Barring the election of a Democratic Governor in 2014 – I’ll leave it to you to estimate the odds of that – it’s pretty much a moot point anyway. Since in adding this amendment SB7 was altered from the Senate version, it has to go to a conference committee, so the amendment could wind up getting stripped anyway. But in all honesty, it probably doesn’t matter anyway. BOR and Trail Blazers have more.