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Just don’t call it “Medicaid expansion”

It’s the public policy that dare not have its name spoken, at least by Republican legislators.

It's constitutional - deal with it

It’s constitutional – deal with it

State lawmakers renewed efforts Thursday to find a “Texas solution” to expand health-insurance coverage for low-income residents without accepting the Medicaid expansion in President Barack Obama’s signature health care law.

Social-services advocates and local officials are among those pushing for a compromise measure that gives the state more flexibility than in the law to spend the money available from the federal government to cover more residents.

On Thursday, the state Senate Health and Human Services Committee met to “start a conversation that will give us an accurate picture of who the uninsured are, what services are available to them and what we can do to help them,” said chairman Charles Schwertner, R-Georgetown.

Katrina Daniel of the Texas Department of Insurance said about 6.5 million state residents do not have health insurance, although some of those can afford insurance and have chosen not to purchase it. An estimated 1.3 million uninsured Texans earn less than the federal poverty level, leaving them in the so-called “coverage gap.” The president’s law assumed all states would expand Medicaid, so it left those eligible for Medicaid out of its subsidies to help poor residents buy insurance.

Caring for those and other uninsured residents is costing counties billions of dollars a year, according to a letter sent to Schwertner on Wednesday by the judges in Harris, Bexar, Dallas, Tarrant, Travis and El Paso counties.

“We write not to complain about this fiscal burden or duty, but to urge your committee to use this interim to find a Texas way forward to fund and increase access to healthcare coverage for low-wage working Texans,” the judges wrote.

Two of those county judges are Republicans, of course, and frankly I think they have every right to complain. The cost of health care for those uninsured people comes out of their budgets, not the state’s. A lot of that cost includes treatment for folks with mental illness, who generally get that treatment in county jails. Medicaid expansion solves a whole world of problems, we just have to be smart enough to take it. If that means calling it something else, or coming up with something that’s almost but not quite exactly Medicaid expansion so we can claim it’s a “Texas solution”, then so be it. Either is better than what we’re doing now.

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