AUSTIN -- Whether on their feet or with the help of a wheelchair, hundreds made their way down Congress Avenue on Tuesday to demand lawmakers expand Medicaid under the Affordable Care Act.
At an estimated cost of roughly $15 billion over the next 10 years, the state would draw down $100 billion in federal money to expanding coverage to more than a million Texans just above the poverty line. For many, it's personal.
"They don't approve hardly nobody for Medicaid," said Houston mother Latoya White, who spoke with KVUE after addressing Tuesday's crowd. "I have sickle cell, and last year I almost died of my sickle cell crisis. I have three children. If I die, where are my kids going to be? They don't seem to care about me or my children. They don't seem to care."
"They talk about it in dollars and cents up here, but I don't think they see the personal face to it all," said Dallas resident Francis Key. Disabled in a car accident 20 years ago, Key says volunteering to help other disabled citizens opened his eyes to the additional hardships many at lower end of the economic ladder face.
"We see many of these patients fall through the cracks," said Dallas physician Anna Tran with Doctors for America. "The hospitals basically bear the brunt of what's going on. We see firsthand the devastation of not having people on coverage."
"For us it's an ethical, a moral and a financial reason," Tran explained of the majority of the medical community's support of Medicaid expansion. "There's lots of physicians who have to do free care because there's no other. We take an oath to take care of our patients so no one is turned away."
While hundreds rallied outside Tuesday, a debate is going on inside the Texas Capitol. While the U.S. Supreme Court ruled it's up to states to decide whether to expand Medicaid under the Affordable Care Act, Republican led states such as Arizona, Florida, New Jersey and Ohio have one by one opted for expansion after initially opposing the idea.
"Why would we put more people into a system that already is broken, that already is taking up 25 percent of our budget?" Gov. Rick Perry (R-TX) asked last week in response to news Gov. Chris Christie (R-NJ) intends to expand Medicaid in New Jersey. Perry and other Republican leaders have steadfastly opposed expansion, yet there are signs a compromise could be possible.
House Republicans reaffirmed their opposition to expansion as defined under the Affordable Care Act after a caucus meeting on Monday, but some voiced a willingness to work towards covering more Texans if the federal government will grant Texas more flexibility.
Physician and state Sen. Bob Deuell (R-Greenville) argues that neither Texas nor the federal government can afford expanding Medicaid. Pointing out Medicaid is already underfunded in Texas, Deuell suggests the expansion may drive up private premiums by allowing some who could potentially afford health insurance to qualify for Medicaid.
Citing a recent compromise between the federal government and Arkansas, Deuell suggests a federal block grant for health care would allow Texas to accomplish the same goal of covering low-income citizens through a customized state health care exchange and non-insurance options such as health savings accounts.
"My plan increases the pool. It gives flexibility, and it gives health care access to those folks that they're trying to cover," said Deuell.
"We're not going to go away or shut up until we get what we need," said Key. "I just hope that they take us serious, they realize that we're informed, we're aware, and we're just not going to sit by and let them vote away our health care."