AUSTIN (AP) — State lawmakers spent hours Thursday discussing ways to better provide low-income residents with health care since Texas has rejected the expansion of Medicaid under the federal Affordable Care Act, but the hearing ultimately generated more questions than answers.
Texas is looking for market-based alternatives to expanding Medicaid under the law, including negotiating with the federal government to provide Medicaid block grants and waivers. But Sen. Charles Schwertner, R-Georgetown, opened a Health and Human Services Committee hearing by saying he didn’t see much hope of reaching an agreement and instead offered to “start a conversation” on different approaches.
Texas leads the nation in uninsured residents, with 6.4 million Texans, or nearly a quarter of the population, lacking health care coverage. Before the hearing even began, county judges from the state’s six largest counties sent Schwertner a letter imploring the Legislature to find a unique, “Texas way forward” to expanding health coverage to low-income Texans.
“The current cost of uncompensated care provided to Texans by public and private providers is over $4 billion a year,” said the letter, which was signed by judges in Harris, Dallas, Tarrant, Bexar, El Paso and Travis counties.
A recent White House report found that Medicaid expansion would have covered an additional 1.2 million Texans by 2016. Still, Gov. Rick Perry and the GOP-controlled Legislature have refused expansion, rejecting the full federal health overhaul as misguided, “one-size-fits-all” policy Washington is attempting to impose on the states.
On Thursday, several committee members raised concerns about the numbers of Texans who may have lost their jobs because their employers imposed cutbacks in order to meet the health law requirements. Others asked if health insurance rates were on the rise as insurers adjust to the law.
“We’re going to have more and more people working two jobs because they can’t get one full-time job because of these mandates,” said Sen. Larry Taylor, a Friendswood Republican.
But top state insurance and health officials said it’s still too early to tell if large numbers of previously insured Texans lost their health coverage, or if health insurance rates will indeed rise.
Around 3.8 million Texans are Medicaid recipients. But Health and Human Services Commissioner Kyle Janek told the committee that Texas’ Medicaid caseload could increase by 600,000-plus — even though the state isn’t expanding the program under the federal law.
Janek said that Affordable Care Act-related Medicaid enrollments may rise from around 90,000 in fiscal year 2014 to more than 722,000 by fiscal year 2017. That’s mainly because the law changed income requirements to qualify, meaning more young Texans will move from the state’s children’s health care program to Medicaid.
It’s also due, however, to what Janek called “outreach,” publicity associated with the federal law which alerted many low-income families around the state that they did indeed qualify for Medicaid coverage even though they’d never previously known to apply for it.
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