A new push for Medicaid expansion gains momentum in Austin

The announcement from Gov. Greg Abbott rescinding the statewide mask mandate and giving permission for businesses to reopen at full capacity is a stark reminder that the state of Texas often doesn’t care about the health of its citizens. As the state legislature’s session continues in Austin, a renewed push for Medicaid expansion, during a national pandemic, is really testing the limits about how much Texas really hates a functioning healthcare system.

Texas often likes to boast that’s it’s the number one state in the country (even if some Texas Republicans are trying to secede). In one area, Texas is number one, but it’s nothing to brag out: the state leads the nation in the number of uninsured.

The number of uninsured Texans has also skyrocketed since the COVID-19 pandemic began last year. According to a report from 2018, over 17 percent of Texas residents lacked health coverage. That’s about 5 million Texans without access to health care. However, last summer it was predicted that another 650,000 have lost their health insurance and that number has surely gotten higher.

Texas is just one of 12 states that hasn’t expanded Medicaid. When the Affordable Care Act passed, Texas refused the Obama administration’s help in expanding Medicaid, leaving millions of federal funds on the table. And while other states have learned from that folly, Texas has not. 

Last year, Missouri became the 38^th state to expand Medicaid, opening healthcare to over 230,000 Missourians. It joins a lengthy list of GOP-led states in expanding health care, including Nebraska, Utah, and Oklahoma.

In Austin, several House and Senate Democrats have targeted Medicaid expansion as one of their legislative goals, most notably state Senator Nathan Johnson from Dallas. Johnson has written op-eds and recorded videos about the benefits of expanding Medicaid. According to Johnson, if the state expanded Medicaid, 1 million more Texans would have access to healthcare and it would add $2.5 billion to the Texas budget.

In 2019, Johnson filed a bill, SB 524, that would have placed Medicaid expansion on a November ballot for statewide approval. Johnson actually described the bill as “a conservative action.” He further noted, “Over the past several years, the 36 states that have expanded Medicaid – including those led by Republican majorities – have benefitted from improved health and net economic benefit.”

Two years later, there is actually bipartisan support for Medicaid expansion. State. Rep. Lyle Larson, a Republican from San Antonio, has voiced his support in expanding Medicaid. He even wrote an op-ed in The Austin American-Statesman about why he thinks now is the time to expand Medicaid coverage.

“Refusing to expand Medicaid is a bad business decision for Texas. We have an opportunity this legislative session to fix this. If the Legislature approves, we can allow Texans to decide whether to expand Medicaid in a ballot initiative,” wrote Larson in the op-ed.

While Larson supports Medicaid expansion, his version would come with certain work requirements and some cost-sharing premiums. Larson, though, is expressing a viewpoint held by many Chambers of Commerce throughout the state: Medicaid expansion really does make financial sense. Five Chambers of Commerce, including Ft. Worth and Arlington, sent lobbyists to Austin to make the case in 2013.

On Twitter, State Rep. Julie Johnson shared a report from the Episcopal Health Foundation indicating that 69 percent of Texans would like to see Medicaid expanded. She also seemed open to leaving the decision to Texas voters.

State Senator Nathan Johnson did file a Medicaid expansion bill in November, SB 117. It is still waiting for a committee assignment.

Photo: Bill Clark/CQ Roll Call