Governor Perry Raises Taxes in Harris County by Denying Medicaid Expansion

Here's some information, pouhe. From the Houston Chronicle, a few days ago:


Gov. Perry leaves a million Texans without health insurance


By Lisa Falkenberg

November 8, 2013

By all accounts, the Obama-care rollout has been a disaster.

Glitches have morphed into major malfunctions that have slowed enrollment to a relative trickle and frustrated many of the millions of Americans who have tried to log onto Healthcare.gov. Applicants have faced error messages, delays, blank screens. They've heard apologies and assurances from officials that provide little comfort or confidence that the problem will be resolved soon.

Even Obamacare architect, U.S. Sen. Max Baucus, D-MT, didn't hesitate to criticize U.S. Health and Human Services Secretary Kathleen Sebelius this week for not seeing the train wreck coming.

But, best as I can tell, nobody wrecked the train on purpose.

The problems were the result of mistakes or incompetence, not willful decisions. The same cannot be said for Texas Gov. Rick Perry's decision not to expand Medicaid eligibility requirements under the Affordable Care Act.

In the state with the most uninsured people in the nation, about 1 million Texas adults, according to the Kaiser Family Foundation, will be left without any access to health coverage as a result of that decision. That will also cost the state tens of billions in federal funding.

Anne Dunkelberg, health policy analyst at the Austin-based Center for Public Policy Priorities, said she's been "dismayed" by the troubles with the federal health care website although she believes it's fixable.

"It's not acceptable," Dunkelberg said. "But it perhaps becomes sort of a distraction from the fact that deliberate choices have been made to offer no coverage of any kind to around a million uninsured U.S. citizen adults in Texas."

These folks - about 27 percent of the state's uninsured adults who aren't elderly or disabled - aren't destitute enough to qualify for Medicaid under Texas' stingy requirements, but they're too poor to get tax credits through the health exchanges.

"We could have a family of four - two parents, two kids- living on $22,000 a year. And the parents get no help because we haven't done Medicaid expansion," she said. "But if the family is earning $25,000 they will have help, and so much help it will be a dramatic, very low premium or no premium."

Stuck in 'coverage gap'

The first family is stuck in a "coverage gap." And Perry helped put them there, resisting arguments from economists, county judges, local hospital district officials, chambers of commerce, lawmakers from both parties, and others who pleaded with the governor to listen to reason.

President Obama pleaded again this week in his visit to Dallas, urging Perry to help a large segment of the working poor obtain health coverage with relatively little state investment.

"There's no state that actually needs this more than Texas," Obama said.

Perry - no surprises here - stuck to his guns. His argument is that he doesn't want Texas further entangled with a flawed Medicaid program that already eats up a quarter of the state's budget. He also believes the feds will eventually reduce their share of the costs of the expansion and leave states holding the bag.

Medicaid has its problems, no doubt. But Perry wasn't even willing to entertain bipartisan legislative compromise known as the "Texas Solution," which sought to expand Medicaid with certain caveats, including cost-sharing by patients.

And, even if the feds pull the rug out in a few years, Texas could always scale back Medicaid if officials deemed it necessary. There's no one-way door as Texas Attorney General Greg Abbott, who's running to succeed Perry, tried to claim a while back.

Keeping an open line

David Lopez, president and CEO of the Harris Health System, says he's still keeping an open line of communication with the state and trying to explain the impact not expanding Medicaid will have in the Houston area.

"If the state can find a billion in the next five years to commit for Medicaid expansion, the state would receive about $20 billion in federal dollars," Lopez said.

If not, if Perry doesn't come around and the next governor continues to block expansion, it will not only leave the hospital district with the burden of caring for more uninsured, but it would also cost the system millions more in federal funds it currently gets to pay for charity care.

Reductions in that funding, starting next year, were written into the Affordable Care Act because it was assumed that hospitals would provide less charity care due to Medicaid expansion. Last fiscal year, revenues from that funding and uncompensated care totaled $272.4 million for the Harris County system, although officials can't yet estimate how much they'll lose.

"It does get a little bit frustrating, but we've got to keep telling the story of why this is important," he said. "It's not about money. It's about people needing care and whether they're able to receive it or not."

Yes, that's what it's about. And that makes me wonder: If a dysfunctional website constitutes a disaster, what should we call our governor's decision to deprive a million Texans access to health insurance?

http://www.houstonchronicle.com/new...s-a-million-Texans-without-health-4966077.php

 

Glynch, I understand the connection you are making but Pouhe is right that this is a misleading thread title. Just for thread form you should've at least provided a link to the article that Deckard did.

Also Pouhe is hardly a Fox News watching troll.

 

Completely agree.

 

Deckard

I am a bit confused by this article. It states that Perry's decision leaves one million Texans without health insurance. Does it really mean that there are that many without "affordable" (whatever affordable may be defined as) health insurance? Isn't "Obamacare" available to these folks regardless of Perry's decision?

Thanks

 

ACA subsidies don't apply to people that would be eligible for medicaid expansion. The intent was that anyone below a certain income level would get medicaid but the supreme court messed that up by giving states the power to opt out of medicaid expansion. The ACA wasn't designed to account for this so those families that would've been eligible for medicaid expansion aren't eligible for subsidies.

 

"Obamacare" doesn't directly provide health insurance or health care. Medicaid is for those who cannot afford private insurance and is jointly financed by states and the Federal government and states have a large leeway in determining eligibility. As part of the ACA there is an increase in Medicaid which states can opt of which Texas has. Yes these people have access to the healthcare.gov exchange (provided it is working) but that doesn't mean they can get insurance since they are too poor.

Whoops I see Geeimsobored posted largely the samething. Odd coincidence is that he, Bobrek and I are all in Minnesota which both opted into the ACA Medicaid expansion and also has it's own online exchange.

 

But they are eligible for insurance (just at more cost than otherwise) - correct?

 

Of course but its definitely not affordable.

 

They beat me to it, bobrek. -