Texas has an opportunity to expand health insurance coverage

For about a quarter of uninsured Texans, there has been a solution since 2014 that leaders could have adopted – the expansion of Medicaid under the Affordable Care Act. While the state’s political leaders still refuse to accept this straightforward solution, there’s a new opportunity in Texas for coverage to expand.

Texas has the highest number (more than 5 million) and the highest percentage (18.4 percent) of residents without health insurance. The problems caused by these high numbers are well documented. Uninsured Texans who do not have access to basic preventive and primary care have poorer health outcomes. Add to this the unsustainable financial pressure on service providers and the shifting of health care costs from the uninsured, often in expensive hospitals, to the insured.

The political gymnastics under way to tackle this lingering problem is reaching new heights.

First, there is growing support for expanding health insurance. Survey data shows Texans’ support for expanding coverage has increased year-on-year to 69 percent in 2020. For these reasons, just over half of the members of the Texas House, including Democrats and some Republicans, signed a bill this year entitled “Live Now Texas,” which would have required Texas coverage by a 1115 Medicaid- Had to expand waiver. Despite this support, the legislature has not given the bill a hearing.

Texas has been working under a Medicaid 1115 leave of absence for a decade now, designed to prepare the health care system for the influx of new patients who will be insured after the ACA is fully implemented in 2014. The exemption included funding system innovations and a pool of funds to cover care costs for uninsured Texans, the number of which was expected to decrease over time as more insured members joined. Next month, Texas will file a request with the Biden government to extend the 1115 exemption.

That month, the Texas Health and Human Services Commission held hearings to gather public opinion on the Medicaid 1115 waiver application. Dozens of speakers across Texas attended, supporting the state’s request to expand coverage. I was one of the participants in a more than four-hour hearing on June 15 where dozens of speakers advocated that the state include expanding coverage as part of the waiver motion. These advocates have included representatives from hospitals and clinics, medical organizations, the faith community, the disabled community, and regular Texans who want their leaders to enable their Texans to get health insurance.

Second, Congressional leaders and the Biden administration are committed to ensuring that Americans living in Texas and the other 11 remaining states that have not expanded Medicaid can get affordable health coverage. New incentives in the American Rescue Plan Act have made it clear that Medicaid’s expansion is affordable for Texas. In addition, Texas Rep. Lloyd Doggett, chairman of the House Ways and Means Health Subcommittee, filed the COVER Now Act. If this bill is passed, local governments could work directly with the federal government to expand local Medicaid coverage, even if their state refuses to participate. Across Texas, the county taxpayers are providing billions of dollars in property taxes to cover health care costs for uninsured residents that would be covered by Medicaid’s expansion. Because of this, many district leaders, both Republicans and Democrats, have spoken out in favor of Medicaid expansion. Other proposals being discussed at the federal level include providing low-income Americans in non-expanding states with subsidized coverage through the ACA market. Since expanding coverage is a priority for the Biden administration and Center for Medicare and Medicaid Services administrator Chiquita Brooks-LaSure, we should expect more innovative ideas to address the problems Texans in the “coverage gap” continue to face are faced.

Third, following the recent US Supreme Court ruling that upheld the Affordable Care Act a third time, by a greater margin than the previous two, it is clear that the ACA will stay here. It is time we all, including the Texan leadership, accept this reality and do all we can to cover more Texans. Our executives will have the opportunity to do so in the coming months as they work with the Biden administration to prepare a new Medicaid 1115 waiver. Together they can develop a Texas insurance solution that will provide affordable health insurance to more than 1 million Texans while protecting our safety network providers. These are complementary solutions to a Texas size problem.

Necessity makes inventive, says an old proverb. We are beyond need. Whether the expansion of coverage comes from Medicaid or a Texan alternative under a different name, be it counties or the ACA marketplace, it is time to move on to invention.

Marks is President and CEO of the Episcopal Health Foundation and a non-resident health policy fellow at Rice University’s Baker Institute.

source https://dailyhealthynews.ca/texas-has-an-opportunity-to-expand-health-insurance-coverage/