Texas Medicaid Expansion- An Issue of Democrats vs Republicans, not healthcare

Rick Perry is doing a huge disservice to Texans by refusing to accept Medicaid expansion offered by the Affordable Care Act. Texas should have implemented Medicaid expansion at the very beginning considering that we have one of the largest overall populations and we have the largest uninsured population of any state.  The economic and social benefits we would see with Medicaid expansion are incredible considering the need and current situation in Texas.

Let’s take a high-level overview of the current healthcare costs in Texas…

We may not be implementing Medicaid expansion but that doesn’t mean our money isn’t being used to fund it. Taxes paid to the federal government, including income, corporate, and estate taxes, will ultimately be used to fund other states implementing Medicaid expansion. In fact, Texas will end up losing $9.2 billions by not expanding Medicaid. Conclusion: we are paying for other states to implement Medicaid expansion.

Being uninsured doesn’t mean people don’t need healthcare. So, what do these people do when they do need healthcare services? Often times they utilize emergency services and are treated in hospitals. Sometimes these are the only options they have because it is against federal law for hospitals who receive Medicare payments to refuse treatment to any person. Uncompensated care is care provided to uninsured and underinsured patients at no cost. In 2010, uncompensated care provided by Texas hospitals was more than $5 billion. So, who covered these costs? Local taxpayers do.  Conclusion: Texans are already paying for uncompensated care provided to uninsured people.

In 2012, 24% of Texas population were uninsured, a total of 6,252,600 individuals. Medicaid expansion would allow more than 1 million Texans to receive coverage.

By accepting Medicaid expansion, the federal government will pay for 100% of program costs for the next three years. After the first three years, the state would then contribute 10% with the federal government contributing the rest. It has been estimated that Texas would have to spend $15 billion over the next decade to roll out the program, but we would be drawing down $100 billion in federal funds. The state would see approximately 9 to 1 return on investment.

So…

• We have the opportunity to provide health insurance to over 1 million Texans who are currently costing taxpayers through uncompensated hospital care and other emergency service costs. 
• We have the opportunity to save millions of dollars with a 9 to 1 return on investment.

If a program has the potential to improve the health of Texans as well as provide economic benefit to the state and local governments (as well as hospitals)… what would be the opposition? The opposition can only be explained by politics and downright stubbornness. Medicaid expansion is a result of the Democratic presidency of President Obama. It is more important to Rick Perry to oppose an Obama-created opportunity than to improve the health of Texans.

Sources:

• http://www.tha.org/HealthCareProviders/Advocacy/Hospital%20Facts.pdf
• http://www.dallasnews.com/news/politics/headlines/20131204-study-refusal-to-expand-medicaid-is-costing-texas-billions.ece
• http://www.burntorangereport.com/diary/14483/refusing-to-expand-medicaid-will-cost-texas-9-billion

Critique: Burkablog on Medicaid Expansion

Earlier this month, Paul Burka wrote a blog post titled Asleep at the Switch discussing how the success of Medicaid expansion in other states could be a very powerful argument for Democrats. Burka explains that the White House predicts an incredible amount of savings in states that adopted Medicaid expansion as well as a dramatic increase in preventive healthcare. If Texas would have adopted expansion, we could have saved $3.1 billion in 2014 and $10.4 billion by 2017. Burka suggests that Republican leaders’ hatred for Obama has caused them to miss out on an opportunity that would have provided great benefit to the state of Texas. He believes that the only legitimate reason to reject the expansion, in spite of the undeniable economic and health benefits, is simply doing it to “stick it to Obama.“

Burka asserts that the negligence and ignorance displayed by the Republicans for rejecting Medicaid expansion provides an easy argument for Democrats to win. He believes that local government, the medical community, and the business community would be on Wendy Davis’ side if she were to use this as a way to gain support. However, neither Wendy Davis nor any other politician seems to want to be the voice that says Texas should do Medicaid expansion.

I found Burka’s argument to be very powerful and indicative of some of the issues we see in Texas politics. Texans often times express an unwavering dedication to conservative beliefs, which results in many lost opportunities for growth and success. When this stubbornness towards change results in the loss of billions of dollars of federal funds, as well as the improved health of citizens, it seems like something should be done.  

Critique: Women's Rights in Texas

Critique of- Phillips: Davis' filibuster shifts abortion debate to women's rights

Phillips provides a very interesting and well thought out opinion piece on Texas’ current political culture surrounding women’s issues. In her introduction, Phillips reminds the reader that Texas has been a leader in supporting women’s leadership roles in Texas in the past but our current male-dominated GOP leadership unfortunately is not as supportive of women’s rights. Throughout her article, she explains how the debate over the Senate Bill 5 regarding abortions has evolved into a much broader discussion on women’s rights.

I believe that Phillips does a good job of presenting the current situation without allowing any bias to weaken her argument. She explains that the male-dominated GOP leadership “are using the political process to advance their anti-abortion agenda.” However, she explains that Democrats, too, would likely advance their ideas if they were the majority. I think this is an important point to make that brings attention to the problems that can be associated with a legislation made up too heavily of of one political party with strong opinions.

Throughout the opinion piece, Philips details a few recent events that show evidence of the hostility towards women. The major issue, that of Senate Bill 5, enacts certain requirements for women seeking abortions and includes restrictions for abortions clinics which ultimately are aimed to drive them out of business. Additionally, Perry vetoed an act earlier this month aimed at ending pay discrimination against women. Both of these events contribute to Phillips argument that Texas is dealing with a broad range of women’s issues.

Wendy Davis continues to be a voice for Texas women, which is proving to be a difficult situation considering the political climate described above. However, Philips believes that Davis’ filibuster of Senate Bill 5 has brought much needed attention to women’s issues and seems to think the debate is beginning to favor the democrats.  

Texas Democrats and the Border Crisis Bill

Julian Aguilar, with the Texas Tribune, wrote an article titled Texas Democrats Divided Over Border Crisis Bill on July 15th. The article addressed the current debates regarding the HUMANE Act Bill. This bill addresses the current situation Texas is dealing with concerning the increased number of unaccompanied Central American children crossing the border into the U.S. The bill proposes that all unaccompanied children crossing the border would be treated the same, as apposed to a 2008 provision that gives greater protection to unaccompanied minors from Mexico or Canada.

The article details the debates presented by two Democrats, U.S. Representative Beto O'Rourke, D-El Paso and U.S. Representative Henry Cuellar, D-Laredo.

1. Beto O'Rourke: 
1. Opposes the bill due to the fact that it would cause thousands of children to be rushed through the court process and most likely send children back to the potentially dangerous situations they came from.
2. Does not believe children are offered a fair chance in regards to waiving their immigration hearings because they have little understanding of the law as well as few resources to defend themselves.
2. Henry Cueller:
1. Supports the bill and does not believe any current protections would be taken away from minors. 
2. Sees the bill as a way to help streamline the process by increasing the resources, including 40 additional immigration judges, to ensure that the cases are presented in a timely manner. This is an improvement on the current law in which the wait time can be between three to five years for a child to see a judge.

Due to the impact of this situation on Texas I believe this is an important topic to be following right now. This article presents a good summary and explanation of the various standpoints Democratic leaders in Texas are currently taking on the issue. As with most things, the complexity of this current situation requires political leaders and citizens to take the take to really read and understand the history leading up to our current situation in order to evaluate the best plan of action.