Medicaid expansion debate hits fever pitch at Capitol

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by MARK WIGGINS / KVUE News and photojournalist MICHAEL MOORE

Bio | Email | Follow: @MarkW_KVUE

kvue.com

Posted on April 1, 2013 at 6:32 PM

Updated Tuesday, Apr 2 at 7:41 AM

AUSTIN -- With signs and chants, demonstrators rallied in the Texas Capitol rotunda and right outside the governor's door demanding the state expand Medicaid to more than a million low-income Texans under the Affordable Care Act, also known as "Obamacare."
 
"We're angry," demonstrator Gloria Payne summed up the crowd's mood. "We're angry that the governor is not noticing how hard we're working and how bad we need medical insurance." 
 
"Private insurance companies are outrageous. We can't afford it. It's hard to pay bills and just live day to day let alone try to buy personal insurance. It's just not affordable," said Payne, a working mother of two. "Lord forbid I get sick today, what's going to happen to me?"
 
Budget experts estimate that over ten years, roughly $15 billion in state money would draw down $100 billion in federal funds. Protests threatened to drown out a meeting of Republican leaders opposed to expansion led by Gov. Rick Perry, who Monday reiterated the criticism that Medicaid is broken. 
 
"On its face we would be foolish to continue on to a path that would bankrupt this country and it would bankrupt our states," Perry told reporters at a media conference following Monday's roundtable discussion. Both were attended by the state's top GOP brass, including Lt. Gov. David Dewhurst and U.S. Senators John Cornyn and Ted Cruz.
 
"If you look at the data, those who are covered by Medicaid receive substantially worse outcomes than do those in private insurance or even those with no insurance at all," Cruz said.
 
Perry again argued for more flexibility from Washington, D.C., preferably in the form of a block grant giving Texas the flexibility to design its own health care solution. Perry elaborated more on what that solution would look like Monday, suggesting it would include asset testing and health savings accounts. 
 
"Health savings accounts would be the single best way for all people to have coverage and they'd have skin in the game," said Perry. "So there's a lot of different options. The problem is that the federal government either they don't think they're smart enough or they don't  trust us." 
 
"The state under Governor Perry has not used the money wisely," countered U.S. Rep. Joaquin Castro (D-San Antonio), leading state Democratic leaders in a separate media conference calling on Perry to reconsider. "Medicaid is already means testing. They're asking to further means test that. This is in a state that has the highest number of people with no health care coverage. So I think that what he's doing is putting that forward as an excuse."
 
While brushing off a suggestion that Republican opposition to expanding the federal health insurance exchange could be cooling, Rep. Lloyd Doggett (D-Austin) suggested the exchange could be potential path toward compromise. 
 
"I think that that might provide an avenue for resolving this," said Doggett. "That exchange by the way is something that, in addition to members of Congress, millions of people here in the state of Texas will be able to go online, just as if they were buying a plane ticket, and choose between various private insurance carriers on standardized policy."
 
"I think it's going to be a tremendous asset," said Doggett, with the caveat, "I don't expect them to ever endorse it or like it." 
 
Members of both parties pointed toward an agreement made between the Obama administration and Arkansas to allow private insurance exchanges to expand coverage to the working poor as evidence the federal government may be willing to cut a deal with other states with reservations over Medicaid expansion.
 
According to Forbes, a memo released by the U.S. Department of Health and Human Services Friday suggests the compromise may have issues.
 
Whether leaders can eventually break the impasse, the tensions are clearly rising.

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