Hundreds of protesters gathered at the Texas Capitol demanding Governor Rick Perry join other Republican governors expanding Medicaid for the poor under the U.S. health-care overhaul.
Enlarging the joint state-federal program would allow uninsured Texans to be treated by primary-care doctors instead of relying on emergency rooms, said Roland Goertz, a Waco physician, at the rally yesterday in Austin.
“Working families deserve better than what they get now,” he told the crowd.
Republican governors in eight states, including Chris Christie of New Jersey and Rick Scott of Florida, say they support expanding Medicaid. Perry has objected, and Republicans in the state House of Representatives voted in a private meeting on March 4 to side with the governor.
The U.S. Supreme Court said in June that the federal government couldn’t force states to broaden Medicaid under President Barack Obama’s Patient Protection and Affordable Care Act. That decision let states decide.
Perry wants the Obama administration to let Texas design a Medicaid system with less federal control, meeting specific needs of the second-most-populous state, spokeswoman Lucy Nashed said by e-mail.
“Adding more Texans and dumping more taxpayer dollars into a broken and unsustainable system is irresponsible and bad public policy,” Nashed said.
Until 2017, the U.S. government will pay the entire cost of covering people newly eligible for the program. Thereafter, states don’t have to pay more than 10 percent. The Congressional Budget Office estimates the expansion will cost the federal government about $638 billion through 2023, and states about $63 billion.
The U.S. won’t be able to afford expanding Medicaid in the long run, which will force states to pay a bigger share, said state Representative Brandon Creighton, chairman of the House Republican caucus.
Texas lawmakers question the federal government’s promises given its mounting debt, Creighton said. The state’s share of Medicaid costs is projected to rise from $14 billion in the fiscal year ending in 2015 to $80 billion in 2040, he said.
Texas should find its own approach to providing health care, he said.
“We’re formulating our own analysis that isn’t tied to political trends or moves by other governors across the country,” Creighton said.
Texas had more than 6 million uninsured residents in 2011, or 24 percent, ranking first among states, according to a January report by former Deputy Comptroller Billy Hamilton prepared for Texas Impact, an Austin-based interfaith group.
Expanding Medicaid over the next decade would cost Texas $15.6 billion while the federal government would pay $100 billion, according to Hamilton’s report.
Arturo Cortez, 67, a retired construction worker from McAllen, traveled to Austin to tell lawmakers he wants benefits made more widely available. He and his wife, Blanca, lost some Medicaid benefits and had to change doctors after their income increased last year, he said.
“They told us we were making too much money now,” Cortez said. “It just doesn’t seem right.”
Federal Medicaid administrators permit some states to alter policies and agreed to let Arizona and other states withdraw from the program if financial promises aren’t kept, said Maura Calsyn, associate director of health policy at the Center for American Progress, a Washington research group that promotes “progressive ideas and action.”
“Acting like there is no flexibility is a bit of a cop-out,” she said.