01.25.13

GOP trying to work out a deal on Medicaid expansion, aka Obamacare

Posted in Around The State, Health Care at 6:00 am by wcnews

Looks like the GOP is trying to find a “face saving” way out of their decision not to take billions in federal money to expand Medicaid.

The Affordable Care Act is the federal law that Texas Republicans love to hate, but one top lawmaker says expanding health care for the working poor could happen if federal authorities are willing to strike a deal.

Republican Sen. Jane Nelson, chair of the Health and Human Services Committee, said she hopes the Centers for Medicare and Medicaid Services will allow Texas to receive $27 billion to expand Medicaid. But she said the key is to allow lawmakers to develop a Texas-specific program that will not blow the state’s budget.

“I am still open to anything that will allow us to have the flexibility that we need, and that will also give us the assurance that it’s not going to put us deeper in debt,” Nelson told The Associated Press in an interview.

Expanding Medicaid, the joint state-federal health care program for the poor and disabled, was a critical requirement under the Affordable Care Act designed to make sure 98 percent of Americans have health insurance. But the U.S. Supreme Court ruled that federal authorities cannot require states to expand Medicaid, and so far Texas and more than 20 other states have refused to do so.

Gov. Rick Perry has rejected the Affordable Care Act as an affront on state’s rights and said he wants the federal money with no strings attached in a block grant. The Perryman Group, an independent economic consulting company, estimated that Texas will miss out on $90 billion in increased economic activity and leave at least 1.5 million people uninsured if it does not expand Medicaid.

Nelson said a block grant was not the only way to reach a deal. She said a waiver that would allow the state to develop a tailor-made program within certain federal boundaries might be enough.

A spokesman for the Centers for Medicare and Medicaid Services on Thursday did not have an immediate comment on possible waivers for Texas. Under federal statute, waivers are generally only granted if they expand the number of people eligible, reduce costs or add additional services to the disabled, poor or elderly.

President Obama’s has said in the past his willing to work with states as long as certain conditions are met. But it’s the bidness types like Perryman that are probably leaning on the GOP to find a way to cave on expanding Medicaid. From Perryman’s report titled, Texas has only one rational choice: Expanding Medicaid under The Affordable Care Act.

According to an analysis by The Perryman Group, every $1 spent by the State of Texas to expand Medicaid coverage under the Affordable Care Act (ACA) returns $1.29 in dynamic State government revenue over the first 10 years of the expansion. Medicaid expenditures lead to substantial economic activity, federal funds inf low, reduction in costs for uncompensated care and insurance, and enhanced productivity from a healthier population. When these outcomes and the related multiplier effects are considered, the program actually far more than pays for itself and provides a notable economic stimulus.

“Neither the Affordable Care Act nor the Medicaid program is perfect, and there are many opportunities to provide needed health services in a more efficient and cost effective manner,” said Dr. Ray Perryman, “but if we don’t expand Medicaid coverage as envisioned under the Affordable Care Act, Texas loses an opportunity to enhance access to health care for about 1.5 million Texans and foregoes almost $90 billion in federal health care funds over the first 10 years.”

Free money, economic stimulus, and 1.5 million more uninsured Texans get insurance.  That’s why the law was designed, to make Medicaid expansion a really good deal for states.  At this point it doesn’t matter what the wing nuts have to do to justify this to themselves. It needs to get done for the benefit of our state. They can call it Perrycare for all I care, but get it done.

And this little tidbit from Arizona may add some fuel to the fire, Obamacare Medicaid Expansion Could Put GOP Governors In Awkward Position On Immigration.

Governors who reject health insurance for the poor under the federal health care overhaul could wind up in a politically awkward position on immigration: A quirk in the law means some U.S. citizens would be forced to go without coverage, while legal immigrants residing in the same state could still get it.

It’s an unintended consequence of how last year’s Supreme Court decision changed the Medicaid provisions of President Barack Obama’s health care law. The overhaul expanded the federal-state program for low-income and disabled people. The Supreme Court made the Medicaid expansion optional for states, which complicated things.

Arizona officials called attention to the problem last week, when Republican Gov. Jan Brewer opted to accept the Medicaid expansion.

Very interesting.

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