Remember the canard of Bush years, compassionate conservatism? Well if there ever was such a thing, it is no more in Texas. The original need for the term was for framing purposes because “conservatism” is inherently mean, or compassionless. In Texas we know that compassionate conservatism in an oxymoron. Thankfully no everyone is taking the budget the Texas legislature passed sitting down, Groups blast Texas lawmakers over budget deal.
A group of unions, education groups, disability rights activists, social-justice interfaith groups and health care providers and advocates said Monday that lawmakers at best deserve middling to poor marks for their two-year, $197 billion state budget.
Spokesmen for the Texas Forward coalition denounced the budget package for its tax “giveaways” and for not putting back enough of the $12 billion in spending cuts approved by lawmakers in 2011.
Among the casualties are expanded and full-day prekindergarten programs, remedial instruction for failing students and formula funding of public schools, none of which were funded at pre-recession levels, they said.
“There’s a lot of celebration of mediocrity around this budget,” said Phillip Martin, political director of Progress Texas. The group advocated for Medicaid expansion, election reform, more education funding and an end to what it called Gov. Rick Perry’s “corporate gifts” to political donors through the state’s economic development and cancer research funds.
Martin noted that at least $8 billion of the nearly $12 billion in available state savings would be left unspent under the budget measures reaching the Republican governor’s desk.
There will be an $8 billion rainy-day balance, even if voters this fall approve a constitutional amendment that would trigger use of $2 billion for a water infrastructure fund. Under the budget package, an additional $1.9 billion of rainy day money would be used to reverse a school payment delay and pay for recovery from the 2011 wildfires and last month’s fertilizer plant explosion in West.
Eva DeLuna Castro, senior budget analyst at the center-left think tank the Center for Public Policy Priorities, said lawmakers could have spent billions more to undo last session’s cuts. Instead, she said, they obsessed over holding back most of the rainy day money and were afraid to vote to exceed a constitutional limit on spending growth of non-dedicated state taxes.
“This doesn’t get us back to where we used to be, and we could have gotten there,” she said.
She said lawmakers have budgeted too little for Medicaid by up to $2 billion. Between that and the hoarding of rainy day dollars “it’s like a middle-aged person trying to fit into the clothes they wore in high school,” she said.
Eric Hartman, director of governmental relations for the teacher union AFT Texas, said lawmakers undid $3.4 billion of the $4 billion cut in 2011 from the state’s main school aid program but left “expansion grants” for pre-k programs in the ditch. They put back only $30 million, after cutting $200 million last time, he said.
As EOW has said before it is cruel that a state with so much wealth can continue to let so many suffer unnecessarily. But jus as bad or worse is why they won’t join with business and local governments and try and find a way to expand Medicaid. Their hate for President Barack Obama and the Affordable Care Act (ACA) have so overwhelmed them that they can’t find a way to work out a solution to help those in need. Health Officials Decry Texas’ Snubbing Of Medicaid Billions, (click here to listen).
The state of Texas is turning down billions of federal dollars that would have paid for health care coverage for 1.5 million poor Texans.
By refusing to participate in Medicaid expansion, which is part of the Affordable Care Act, the state will leave on the table an estimated $100 billion over the next decade.
Texas’ share of the cost would have been just 7 percent of the total, but for Gov. Rick Perry and the state’s Republican-dominated Legislature, even $1 in the name of “Obamacare” was a dollar too much.
In other words they’re doing it out of spite.
If your country has no national health insurance but your citizens don’t have the stomach to watch the uninsured die on the hospital sidewalk, something’s got to give. So there’s a national expectation that doctors and hospitals will provide these uninsured populations mostly uncompensated care — and so they do. But few in the industry think this is the way to operate.
Tom Banning, chief executive officer of the Texas Academy of Family Physicians, lobbied hard but unsuccessfully for Medicaid expansion. He’s beside himself with frustration.
“These people don’t choose to get sick. When they do, they’re going to access our health care system at the most inefficient and expensive point, which is the emergency room,” Banning says. “And it’s going to cost the taxpayers, and it’s going to cost employers a lot of money to care for them. And we’re going to be forgoing billions of dollars that the feds have set aside for the state to pay for and provide this care.”
This is not about money — if it were, Texas would be taking it. This is about Obamacare. It’s widely believed in Austin that Perry is seriously considering another run for president — this time without the “oops.” His base is Tea Party Republicans across the country. While it might cost $100 billion for the privilege, Perry is going to be able to stand in front of them and say, “I said no to Obama when he tried to bribe my state with health care coverage for the poor.”
And since it’s widely believed that these would-be Medicaid recipients probably don’t vote or, if they do vote, they vote for Democrats, there’s no political price to pay for snubbing them.
Still, there are some Republican legislators who feel bad about not taking the money.
Rep. John Zerwas tried to craft some sort of compromise that never mentioned Medicaid expansion, but he couldn’t get it out of committee — because for Texas Republicans, the very words “health care” now carry the stink of Obamacare.
Zerwas points to “the political realities of having to run for office again in two years, and how much explaining would I have to do as a candidate around a vote that could very easily be framed as a supporter of promoting Obamacare.”
Texas Republicans aren’t worried about the reaction from the left for voting down Medicaid expansion; they’re worried they might get a primary challenge from a Tea Party candidate if the words “health care” pass their lips on the floor of the Legislature. That is, if they’re not already a Tea Party candidate, which many are.
For at least the next two years and probably longer, Medicaid expansion in Texas is dead. What this all means is that more than a million Texans who might have received health care coverage will remain one serious illness or one bad accident away from bankruptcy. And an estimated $100 billion that would have been spent buying health care in Texas will now go somewhere else.
Because of ideology there can be no compromise on an issue that almost everyone, except for those on the extreme right, agree should happen. It certainly seems that compassionless conservatism and spite will keep government in Texas cruel for the foreseeable future.
Texas Gov. Rick Perry was heckled by activists from the Texas Organizing Project (TOP) yesterday at while speaking at a luncheon for small business owners.
Speaking at a luncheon for small business owners at the Austin Hilton, Gov. Rick Perry (R-Texas) was repeatedly interrupted by organized protesters angry over his opposition to expanding Medicaid coverage for poor Texans.
“There’s six million Texans that don’t have health coverage, and we need it,” said Reynaldo Gutierrez, a small business owner from Houston who was asked to leave after interrupting the governor to read a statement. “I don’t have enough money to have health insurance.”
For his part, the governor offered an olive branch.
“If you will leave here, I will invite you to the governor’s office and we will have this debate face to face. How about that?” Perry proposed after several interruptions.
“He listened to us,” offered Connie Paredes with TOP. “But he has his mind set already.”
Baby steps perhaps, just as similar closed door discussions between the House and Senate seemed to reduce some tension as the day progressed.
You can see some of it toward the end of this KVUE video.
A remarkably expensive meeting of a key legislative committee took place this week: a $22,000-plus affair at an upscale downtown Austin steakhouse for the 15-member House Calendars Committee.
That panel, which sets the daily lineup of bills for consideration in the House and thus holds life-or-death power over legislation, held its end-of-session dinner at Austin’s III Forks restaurant this past Sunday.
It cost $22,241.03 and required the use of 34 American Express cards, 11 MasterCards and 20 Visa cards. The committee chairman, state Rep. Todd Hunter, R-Corpus Christi, said there were about 140 people there, and most of them stayed for dinner.
That’s an extraordinary amount of money, as these things go, but the events themselves are common. In a tradition that stretches back as far as anyone can remember, committees in the Texas Legislature throw self-congratulatory dinners to celebrate the completion of their work.
“It’s a large gathering,” Hunter said of the Calendars dinner. “All committees do it. I don’t know how people have done it in the past. I don’t even know the amount. We invite the committee and we invite their staffs, and then we involve lobbyists and outside folks. Some of them are not lobbyists. I don’t know who paid. You can go find out.”
Not all of the 121 people at the dinner — that number is based on the number of $95 “banquets” on the check — paid for their supper. Beverages ran another $6,580, plus tax and tip. Somebody had a glass of juice for $2.75; elsewhere in the room, the restaurant was serving 24 bottles of pinot noir, 24 bottles of chardonnay, 27 bottles of cabernet and seven bottles of sauvignon blanc, each priced at between $51 and $68. Another three bottles of cabernet — a nicer one, apparently — cost $135 each. That’s on top of a long list of mixed drinks and beers. If you’re keeping count, that’s 85 bottles for 140 people.
The full tab was $18,584.55 and after a 20 percent tip was added on, the total came to $22,241.03.
That’s $183.81 per person, but only 65 guests produced their wallets. They divvied the tab evenly, most of them paying $340.07. A handful varied from that amount, with the smallest tab coming in at $338.12 and the biggest landing at $478.07. Hunter said he didn’t pay and didn’t expect the members of his committee to do so, either.
“I’ve had committee dinners since I’ve been here for seven terms,” Hunter said, speaking in characteristically clipped phrases. “Lobby pays. They follow rules. Everybody knows up front. And we even post it, so we are all in compliance.”
The calendars committee is responsible for setting the agenda on the House floor. It looks like the lobby was certainly happy with the job they did. As Lessig says, “Money buys results & erodes trust“.
Yesterday I linked to this article, Texas, Congress go blue if immigration reform goes down at the bottom of a post. It makes the point that if immigrations reform dies so will the Republican Party. While that likely makes some people smile – especially in Texas – if it did happen, something just like it would emerge to take it’s place. There will always be a right wing party, not matter what it’s called.
That being said, sometimes it does look like the GOP is trying to legislate itself into oblivion when it comes to the Hispanic vote. When looking at Medicaid expansion, they have a similar issue. Their rhetoric is against it , which also pits them against those who will benefit the most, Texas Latinos have most to gain from Medicaid expansion, while GOP counties have little to gain. And it’s a political conundrum for the GOP. Being for this may get them beat in a primary, but staying against may just get the Democrat’s foot back in the door in Texas.
Republican leaders in Texas have ideological opposition to Medicaid’s expansion, but also have little political reason to expand a program that would primarily benefit a constituency leaning towards the Democrats.
“Texas will not be held hostage by the Obama administration’s attempt to force us into this fool’s errand of adding more than a million Texans to a broken system,” Gov. Rick Perry said at April 1 news conference. “That’s not just me who said that, by the way. In 2009, President Obama, himself, called Medicaid a broken system.”
Texas is one of 14 states that will not participate. Texas has the highest rate of uninsured population in the country at 24 percent, according to the Kaiser Foundation. For those with incomes 139 percent of the poverty level—those eligible for Medicaid expansion—Texas is second in the nation at 43 percent, one point below Nevada.
Kaiser data also show that a disproportionate number of Texas Latinos are uninsured. A majority of the uninsured in Texas—60 percent—are Latino, despite being 38 percent of the population. Latinos have an uninsured rate of 38 percent in Texas, compared to the statewide average of 24.
Texas appears to be an ideal candidate for Medicaid expansion: The worst health coverage rates, the promise of federal dollars, and its own estimated budget surplus of $8.8 billion.
Latinos are the fastest growing ethnic group in Texas, and are a majority of Texans without insurance. Texas Latino household incomes are about two-thirds the average, indicating Medicaid would disproportionately benefit this group. Yet with low voter turnout, most breaking for Democrats at the ballot, and with few significant competitive races hinging on Latino support, Texas Republican leaders have little reason to make the issue a political priority.
For many Texas Republicans, winning the party primary is the key election hurdle. Just ask David Dewhurst.
The worst area for health coverage are the counties along the border, many ranging from 30 percent uninsured to Texas’ leading county, Hudspeth at 43 percent, according to data from the Population Health Institute.
Jose Luna Jr. has worked as a clinical physician in El Paso for 30 years, serving many of the uninsured. Luna, currently the chief medical officer at Centro San Vincente, strongly supports the Medicaid expansion.
“There are people that I know that will die because of a lack of healthcare,” Luna said in a phone interview. “Patients that I have seen have a higher probability of dying simply because they have a lack of healthcare.”
Luna said he has lists of such patients, including one truck driver who lost his job after a stomach cancer diagnosis. Unable to work, the man lost his health insurance and relied on the clinic where Luna worked for care. The patient was unable to see an oncologist, and Luna said the only care he could provide was painkillers.
Luna said many Latinos in his community work service jobs without the full benefits many other sectors provide, explaining the dearth of insurance coverage.
“Health care should be a human right, not a privilege,” Luna said, describing the attitude towards healthcare he sees in many Latinos. Though Latinos are disproportionately affected by a lack of insurance in Texas, Luna said his support for Medicaid expansion was universal.
Republicans in Austin have little to fear in the short-term in their opposition to Medicaid expansion. However, national Republicans, who made courting the Latino vote a priority after the 2012 election loss, may take a different perspective. A Kaiser Foundation poll found that Obamacare was supported by a two-to-one margin among Latinos nationwide. [Emphasis added]
With Congress undoing the one and only thing you could say was good about the sequester, which is that it bound together the poor, middle class and the wealthy with the across the board cuts, sadly, this should not be that surprising, given their voting records.
In almost every instance, senators appear to be considerably more responsive to the opinions of affluent constituents than to the opinions of middle-class constituents, while the opinions of constituents in the bottom third of the income distribution have no apparent statistical effect on their senators’ roll call votes.
It would be preferable that the Texas GOP wake up and do what is right now, and keep people from having to suffer unnecessarily. But if this is what it takes for Texans to finally wake up and vote in people that will actually make this a reality, then so be it.
Religious leaders and a San Antonio lawmaker are putting their faith behind Rick Perry to be the next Republican governor to work with the Obama administration to expand healthcare coverage in the state.
“We understand that Gov. Perry is moderating his position (on Medicaid) as he sees the needs of real Texans,” said Sister Simone Campbell, executive director of NETWORK, a national Catholic social justice group. “We just have to give him enough room so he can save face and he’ll do the right thing.”
Perry remains firmly opposed to expanding Medicaid, spokesman Rich Parsons said Wednesday afternoon.
Campbell, who has traveled to different state legislatures and Congress with the group Nuns on the Bus since its inception last year, said nine other Republican governors who initially rejected “ObamaCare” have agreed to expand their healthcare programs to meet the coverage requirements of the Affordable Care Act.
“He’s oozing in our direction,” said Campbell before speaking at a rally Wednesday of more than a hundred activists on the south steps of the Capitol.
Catholic nuns and advocacy groups from San Antonio, Houston, Dallas/Fort Worth and Corpus Christi traveled by bus to Austin to urge lawmakers and Perry to expand Medicaid, which they say will extend coverage to more than 1.5 million Texans who are currently uninsured.
“Some say we should be at home in our convent chapels, praying for the world, not meddling in politics,” said Sister Elizabeth Riebshlaeger, a Sister of Charity of the Incarnate Word in San Antonio. “But we know the doors leading out of our chapels lead here… ”
Kuff has a round up of what happened earlier in the week on Medicaid expansion in House committees, House discusses Medicaid expansion. It’s clear from this that many in the Texas GOP are still trying to find a way in to expanding medicaid.
Text messages to a legislator show that Kyle Janek, Gov. Rick Perry’s point man on health care, was content last week to start planning a trip to Washington to meet with Cindy Mann, director of Medicaid and CHIP services and deputy administrator of the U.S. Centers for Medicare & Medicaid Services.
In the world of health care acronyms, that agency is CMS. And CHIP is the Children’s Health Insurance Program.
“Kyle, can you check your schedule for you and I go to Washington?” Rep. Garnet Coleman, D-Houston, texted Janek on April 1.
“You bet,” Janek swiftly replied. “Let me look at some dates. Given the House calendar, should I look at Mondays/Fridays or is it all getting to be the same now?”
Coleman responded, “Either. I will see when I can get in.” Early Wednesday, Coleman continued the exchange of messages, mentioning Mann specifically.
But when Coleman spoke to reporters around midday Wednesday about the planned trip, and the reporters spread the news, Janek’s office got a little uptight. One can only presume that Perry’s did, too.
But this is the money quote:
“No meeting has been scheduled yet. As you know, legislators are still considering several options. Once they’ve reached a consensus we’ll have the detailed guidance needed to begin negotiations with CMS on Medicaid reform. We have ongoing talks with CMS on a variety of topics so we’re always open to trying to get more information from CMS on any of the options being discussed.”
These two videos do a pretty good job of laying out the idiocy of Perry and the wing nuts stance against expanding Medicaid in Texas. The first video sets up the issue and also replay’s Perry’s “Oops” moment – it’s worth watching just for that.
The second video includes Congressman Joaquin Castro (D-Texas) and has a great explanation of how bad it will be for Texas if Medicaid isn’t expanded. Castro does think Texas will eventually find a way to expand Medicaid, whether under this governor or the next governor. Ezra Klein does a great job of explaining how “disproportionate share” payments will negatively effect Texas. And Ryan Grim does a good job of explaining the ideological box that Perry and the wing nuts have put themselves in.
Kuff has this post on a purported Medicaid reform plan by Sen. Tommy Williams. The sad part is that like his wing nut leader Perry, Williams is incapable of saying he’ll have anything to do with Medicaid.
Of course, the federal government is paying for it, assuming that Williams’ Republican colleagues in Washington don’t succeed in figuring out some way to cripple it. One must admit there is some risk to that, however perverse the whole thing is. Be that as it may, I’d like to know how much revenue Williams thinks he can “scrape” this way, and how many people it would help. I’m going to step out on a limb and guess that the number is smaller than the number of people who would be eligible for expanded Medicaid. More importantly, why this for a revenue source and not the billions of dollars of federal money available? Back to the Trib for that:
State Rep. John Zerwas, R-Simonton, confirmed Wednesday that he will incorporate into his own Medicaid reform bill a proposal by Sen. Tommy Williams, R-The Woodlands, to use premium tax revenue to subsidize private health policies for the uninsured.
“It fits very well with Texas’ attempt to find a unique solution that would be sustainable,” Zerwas said. He said the measure would allow Texas to embrace some parts of federal health reform “earlier versus later,” and would “hopefully bring insurance policies to these people that otherwise wouldn’t have them.”
But the two lawmakers diverge on a key point — whether or not to draw down billions of federal dollars to expand the state’s Medicaid-eligible population under the Affordable Care Act.
Medicaid expansion is “completely off the table — what I’m interested in is a reform program,” Williams said Wednesday morning.
Zerwas said he authored House Bill 3791 to craft a “Texas solution” to Medicaid reform that would allow the state to draw down federal Medicaid expansion financing while implementing cost containment reforms. So far, Zerwas has suggested those reforms include co-payments and wellness incentives, but the details of his plan remain thin.
Still not clear what, other than straight up antipathy to Medicaid and the ACA, is driving Williams’ refusal to draw down federal funds. The sad thing is that even this baby step, two years out, would be a big improvement over anything the Republicans have done to health care in Texas. It’s ridiculously limited and needlessly complicated, which gives you some idea of just how bad the status quo is, but it’s still a tiny nudge forward. I just hope Rep. Zerwas’ perspective wins out in the end.
The only silver lining we can hope for is that the Texas GOP’s immoral stance on health care will make them vulnerable in Texas much sooner. Now that would be the miracle we need.
This morning, volunteers with Progress Texas and the Texas Organizing Project rallied outside Governor Perry’s office demanding he expand Medicaid in Texas to cover hard working Texans. Perry hosted a 10 minute long “roundtable” discussion – where no members of the public were invited – and a joint press conference on Medicaid expansion with Senators John Cornyn & Ted Cruz, along with other Texas Tea Party members. Texans came from across the state to make it known that we need health care, and we need it now - check out our Facebook photos from the rally.
Republicans including U.S. Sens. Ted Cruz and John Cornyn, Gov. Rick Perry, Lt. Gov. David Dewhurst and members of a conservative think tank gathered first, reaffirming their opposition to expanding Medicaid, a key tenet of “Obamacare” that is widely supported by Democrats. The expansion — and, in particular, the flexibility the federal government has shown some Republican-led states in implementing it — has in recent months drawn the support of some fiscal conservatives reluctant to pass up billions of federal dollars and the opportunity to curb Texas’ ranks of the uninsured.
The Republican event was followed by a Democratic one led by U.S. Rep. Joaquin Castro, D-San Antonio; his brother, San Antonio Mayor Julián Castro; U.S. Rep. Lloyd Doggett, D-Austin; and legislative Democrats. They demanded that state leaders find a way to draw down the federal money and lift Texas’ stigma as having the highest uninsured population of any state.
“Even though many states with staunch Republican governors have said expanding Medicaid is the smart thing to do, the governor has stubbornly refused to do so,” Joaquin Castro said.
Julián Castro said: “As elected officials, the public hires us not to do the ideological thing but to do the smart thing. People from across the political spectrum … have suggested that Texas should do the right thing and accept the expansion of Medicaid.”
“This is federal money that is going to be spent whether we opt into the program or not,” he said. “In other words, if we don’t reclaim our federal dollars that Texas taxpayers are paying, they’re going to go to other states.”
There is nothing that can be said to fight against the ideological bias of Perry and the wing nuts. They will not compromise on anything Obama related. The Democrats in Texas, the Obama administration, and many traditional GOP supporters are willing to work on a deal. But Perry and the wing nuts, who have locked themselves into an ideological box, are unwilling to compromise on this, the moral choice of our day.
Businesses are often allied with Perry, a failed contender for last year’s Republican presidential nomination. The chambers, however, argue Texas shouldn’t pass up $100 billion over the next decade to cover 1.5 million adults. Obama’s plan would pay all costs until 2016, then the state’s share would gradually increase to 10 percent in 2020. Perry says that’s too expensive.
“This may be the only time that we have taken an actual formal position that is opposite that of the governor,” said Richard Dayoub, chief executive officer of the El Paso Chamber of Commerce. “I don’t know of any issue that has created so much concern across the state and has amassed so much support across party lines and throughout the business sector.”
Chambers supporting expansion in Dallas, San Antonio, Fort Worth and Arlington include members ranging from publicly traded companies to small shoe stores and family restaurants, many of them strained by health costs.
With so many uninsured in Texas this seems to many business and corporate Republicans as a no brainer.
About 29 percent of Texas citizens lack insurance, according to a March 8 poll by Gallup Inc. The state ranked 40th in health last year because 30 percent of residents are obese and one of every four children lives in poverty, according to United Health Foundation, affiliated with UnitedHealth Group Inc. (UNH).
Hospitals have urged expansion because it will reduce expensive and ineffective emergency-room visits, said Stephen Mansfield, chief executive of Methodist Health System in Dallas and next year’s chairman of the 2,100-member Dallas Regional Chamber.
“The eight other Republican governors were just as opposed to this initially as Rick Perry,” said Mansfield, who met with him in February. “They came to understand the economics.”
Chamber lobbyists from Dallas, Fort Worth and San Antonio have discussed Medicaid with legislators during the current session in Austin, officials said. Dayoub of the El Paso chamber spoke with Lieutenant Governor David Dewhurst and House Speaker Joe Straus, both Republicans, and about 35 legislators of both parties.
Business groups “are looking short term,” said Republican Senator David Duell, a Greenville physician who met with chamber representatives. He said he doubted the Obama administration’s commitment “with the long-term viability of the federal government in question.”
Such opposition is “idiocy,” said Margaret Jordan, a former Federal Reserve Bank of Dallas director who is president of Dallas Medical Resources, a consortium of hospital executives and businesspeople headed by billionaire oilman Ray Hunt. “Medicaid expansion is a win-win for everybody.”
Refusing to expand Medicaid could cost Texas employers as much as $448 million in fines because the 2010 law penalizes some companies when workers can’t obtain affordable coverage, Jackson Hewitt Tax Service Inc. said in a March 13 report.
Perry and other opponents will compromise because of pressure from hospitals and businesses, Trevor Fetter, chief executive officer of Dallas-based Tenet Healthcare Inc. (THC), said in an interview Feb. 27. Tenet is the third-largest U.S. hospital firm.
“There isn’t a scenario I can envision that is worse than the status quo in Texas,” Fetter said.
The problem for the “bidness” community in Texas is that Perry is no longer accountable to them. He’s now controlled by his ego and adherence to extreme ideology. But they only have themselves to blame. They created this monster and have allowed it to grow beyond their control. And now that something they want and need is not ideological pure to the politicians they’ve been bankrolling, they’re unable to turn the screws.
The influence of business on Texas Republicans is modest compared with that of evangelicals and Tea Party-affiliated groups, said Mark Jones, who teaches politics at Houston’s Rice University.
“The Republican base views Obamacare as a matter of principle, while the monied interests view it as a dollars and cents issue,” Jones said.
And it doesn’t look like anything anyone says, not matter how logical and sound it may be, can change their mind. That kind of argument doesn’t work on ideology.
Duncan, however, says Texas can’t afford the deal because Medicaid crowds out spending for education, parks and other priorities.
“It’s not a free lunch,” Duncan said. He said he was unconvinced by studies by former deputy State Comptroller Billy Hamilton and Waco economist Ray Perryman suggesting expansion would boost the state’s economy by increasing business activity and productivity.
It was inevitable. The GOP in Texas has gotten so extreme over the last several years that they can no longer be worked with. They have their agenda and that’s it. It’s sad and funny all at the same time. The business community is now reaping what it sowed.
What this article shows is that there are many who support the Texas GOP financially that are for expanding Medicaid. The only one in a position of power that’s likely for Medicaid expansion is Speaker Joe Straus, but he won’t really say it out loud. As stated before, if the far right in Texas won’t go for the greed argument it’s hard to see anything that can trump their ideology.
Yesterday Gov. Rick Perry signed the bill that allowed the GOP to finally pay for Medicaid through 2013, aka the Medicaid IOU. Back in 2011 the one thing they were willing to put in limbo was health care for the neediest among us. While the neediest among us have been taken care of in the current biennium, the issues with the uninsured in Texas continues.
Slicing more skin off the necks of poor people to throw into the game is, frankly, a non-starter. They have already given enough of their lives — children, seniors, and those below the poverty threshold. We are already at the blood-out-of-a-turnip stage in Texas.
– Many working, low-income Texans aren’t offered healthcare coverage through their jobs, and many more simply don’t get paid enough to purchase it. (Forget for a moment the unemployed, the underemployed, and the under-self-employed.) These are the crisis situations: people who put off doctor visits because they cannot afford them, and then go to the emergency room when their health takes a turn for the worse.
– Then there are the personal stories. For example: my father, 86 84, who had a good job all his working life and then a comfortable retirement, is at medium-to-end-stage dementia and has essentially outlived his assets. So it’s humiliating enough for seniors like him who find themselves at the prospect of spending the very end of their lives on the government dole (when they are even capable of understanding that). But because health care providers are refusing new Medicaid patients — in large part because the state pays its Medicaid bills very slowly — people like him are falling straight from middle class all the way through the shredded safety net.
And people like him have no advocates. My dad can’t write a letter or an e-mail; can’t make a phone call, can’t go to a townhall meeting to speak to his state rep, can’t march at a rally. You know what’s even worse about his situation, though? If he lived in Arizona, or New Jersey, or Florida, he would be getting covered. Because their conservative governors can see the benefits of expanding Medicaid. Not our governor, though.
I find empathy, however, to be somewhat fungible among Texas Republicans. So a straight appeal to the financials is what we are left with, and it’s a good thing those arguments are pretty solid.
The point is that every way you look at it, this is the right thing to do, and the only rationale for opposition is ideology and a deep indifference to the suffering of others.
Burka’s latest post on expanding Medicaid in Texas makes several points that are worth noting. Joe Straus appears to be for a deal, and if he was in charger there would probably be one already. He’s not, the “wacko birds“, aka wing nuts, are. Unfortunately the only way to get the wing nuts to change their mind is to get Perry to change his mind. And Burka doesn’t see that happening.
Of all the big issues to be resolved by the 83rd Legislature, none is bigger than Medicaid expansion. This has mainly been a House show up to this point, with Joe Straus acting as the leading proponent of moving forward and allowing himself to become the target of criticism on the right. This is an awkward situation for the speaker, as the GOP caucus is already on record as opposing expansion, while Straus is on record as wanting to move forward. When the Republican caucus voted overwhelmingly to oppose expansion, Straus wisely let the moment pass. He allowed the opposition to run wild and make their statement.
Every time a situation like this arises, I think it is appropriate to ask of the opponents and the naysayers—I am referring mainly to Michael Quinn Sullivan and Empower Texans, but also of the anti-government faction generally—”What is your solution?” (Sullivan’s group has been hypercritical of Straus but has remained mute about senators who support expansion.) Is it better to turn down federal funds and to dump the cost of health care for the uninsured on hospital emergency rooms and ultimately on local-property taxpayers? Make no mistake about it: The health care costs of the uninsured in Texas are a hidden tax on property. Property taxpayers have to make up the difference in the health care costs of the uninsured, or see local taxes go up. I grant you that there is a cost to accepting federal funds. The cost is in the loss of control over health care policy in this state. But, let’s face it, health care policy in this state stinks. We have great hospitals, great research, and lousy government. I’d rather put the money in the hands of the people who deliver the services than in the hands of the politicians. I suspect this is what Straus thinks too. Forget the ideology. Show me the money.
I fear that Texas is going to let a great opportunity slip through its fingers. State officials, including Straus, appear to insist on a “Texas-centric solution” before they will touch filthy lucre. Unless Straus’s powers of persuasion are superhuman, it isn’t going to work. Medicaid is an entitlement program. If state officials insist upon co-pays, deductibles, and other devices that are incompatible with the concept of an entitlement program, the state is going to pick up its marbles and say no, as it has done in the past. Unless things change, the best we can hope for is to squeeze out some dollars that can be used to obtain insurance for the uninsured. Very few things would be more helpful for business—and taxpayers—in this state.
If they won’t respond to greed then it’s unlikely they’ll respond to anything else. Public pressure is likely the only thing left that can change their minds. So call your representative, especially if you live in a District with a wing nut representative. (Find out who your representatives is here). And click here to see how this will impact your local community.
What this means is that Speaker Straus is for the expansion, and so are most normal Republicans, aka business oriented Republicans. They know this is a good deal and they want it. They just have not yet been able to allay the fears of enough elected GOP members of The Lege that it won’t cost them their seat if they come out in favor of the expansion. They’re more worried of MQS and the GOP base, then they are of the business lobby.
For the fifth straight year, Texas has the highest uninsured rate in the country — the 28.8% of adult Texans lacking healthcare coverage in 2012 is the highest for any state since Gallup and Healthways started tracking insurance coverage in January 2008. This widens the gap between Texas and the state with the second-highest uninsured rate in the country, Louisiana (24.0%), to 4.8 percentage points — the largest number separating these two spots on record. Massachusetts continues to have the lowest uninsured rate in the U.S., at 4.5%.
Yes, the Massachusetts of “Romneycare” fame. That’s almost three in ten Texans without health insurance. Here’s the list of the worst 10, starting with Texas.
But we have “a good reglatory climate” here in Texas. Here’s what the Texas Hospital Association had to say about this:
The following statement is a response from the Texas Hospital Association, which may be attributed to Dan Stultz, M.D., FACHE, FACP, THA president/ chief executive officer:
“Uninsured patients still require health care, and a growing uninsured population strains hospitals, taxpayers, and the insured. An uninsured workforce draws additional concern for what it says about the state’s ability to compete. By expanding Medicaid, however, Texas employers can ensure increased access to primary care, which promotes increased workplace efficiency and decreased morbidity and mortality.”
Medicaid expansion got its first Capitol hearing Friday, with new numbers revealed and deep divides further exposed between Republicans and Democrats in the Texas House.
But most of the action on Medicaid expansion continues to take place in private meetings among leading Republicans, including members of Gov. Rick Perry’s office, as they search for a politically palatable way to negotiate concessions from the federal government. The primary goal is to insure more low-income Texans without significantly expanding a Medicaid program they consider to be bloated and unsustainable.
Against that backdrop, the House Appropriations Committee hearing had an anticlimactic feel, leaving one key Democrat to question its purpose.
“I just need to know where we’re going,” said Rep. Sylvester Turner, D-Houston.
“If this hearing is to put information before us so we can design something in a positive way … then I am more than willing to take the time,” Turner said. “But if this meeting is only for informational purposes so we can say you all came, you spoke, we heard, thank you very much — and nothing is going to move forward — then I got that, and I’m through with it.”
Kyle Janek, head of the Health and Human Services Commission, which administers Medicaid, assured Turner that his agency is not crafting a Medicaid expansion plan, nor would it do so without direction from the Legislature.
What yesterday’s hearing was about was some House GOP lawmakers were trying to make it look like they were doing something on Medicaid expansion, without actually getting anything done. But while they continue to do nothing the situation for the many Texans stays bad or gets worse. How bad does it have to get before expanding Medicaid in Texas becomes politically palatable.