Texas remains one of the 11 states that have refused to expand Medicaid coverage under the Affordable Care Act. On Friday, a group of Texans staged their own “public hearing” at the state capitol to push for the expansion despite official silence from top Republicans this legislative session.
“I’m urging Texas leaders to expand Medicaid because everyone, no matter how much or how little money they make, no matter what kind of job they do, should have the ability to take care of their health,” said Meridith McGee, a hair stylist in Deep Ellum whose home situation puts her in the dreaded gap between the state’s notoriously stingy Medicaid qualifications and the subsidies provided by the federal government under the ACA. Some 2 million Texans remain uninsured thanks to Republican stonewalling.
There was a bipartisan push to finally accept the Medicaid expansion in 2021, partially driven by the COVID crisis. However, bills failed to advance. Since then, no Republican leadership has spoken on the matter or appears ready to consider it. The only movement has been from a minor expansion of Medicaid coverage for post-partum Texans, which was extended to six months in the last session. Some pro-life groups have been pressuring Republicans to extend it again to a full year, but that would still leave 1.4 million adults without insurance.
Governor Greg Abbott has been a staunch opponent of the Medicaid expansion since the ACA was passed in 2010. In 2015 he called it “wrong for Texas” and “a massive expansion of an already broken and bloated Medicaid program,” and he does not appear to have softened any on the matter since.
Despite the portrayal of the Medicaid expansion as a government takeover that will bankrupt the state, accepting the ACA protocols would be covered 90 percent by federal funds. Though nearly all red states opposed the expansion, many have come around. In Oklahoma, nearly 300,000 people gained coverage when they agreed to the expansion in 2021, decreasing their uninsured rate by 33 percent. Like Texas, Oklahoma has a severe problem with declining funds for rural hospitals thanks to uninsured residents. The Medicaid expansion has been instrumental to keeping the lights on since it was passed according to one report.
Several bills pushed by Democrats this session would expand Medicaid, but thus far they have no support on the Republican side of the aisle. House Speaker Dade Phelan, who is one of the more moderate voices for the conservative party, has not brought up the possibility of accepting the government funds to insure Texans.
Currently, the state is deciding what to do with a $33 billion budget surplus, with some vague and undefined focus on healthcare supposedly part of the Republican plan. Rural hospitals in particular are in dire need of funding. A $75 million infusion from the state government stopped the rash of closures that had plagued rural Texas communities over the last decade, but those funds have since dried up.
Amid the Republican silence, Texans took the matter straight to the committee rooms themselves to force a conversation. It appears to be one that Texas Republicans would still rather not have.