Gov. Rick Perry announces Texas will not expand Medicaid -- a program benefiting 1 in 6 Texans in 2009

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Gov. Rick Perry sent a letter today to U.S. Health and Human Services Secretary Kathleen Sebelius announcing that Texas would defy two planks of President Obama’s health care law.

Though the U.S. Supreme Court declared the Affordable Care Act constitutional last month, Perry wrote Sebelius that Texas would not create the insurance exchanges “Obamacare” mandates. For states that choose not to set up exchanges --- one-stop sites for comparing health insurance options --- the federal government has indicated it will do so.

Texas also would not expand Medicaid, Perry wrote.

The Supreme Court’s June ruling also allowed states to legally decline to add to their Medicaid rolls.

That is a big deal, reports Elspeth Reeve today in The Atlantic Wire because:

Medicaid expansion was one of the primary mechanisms that Obamacare was going to be able to achieve its primary goal: increasing the number of people with health care coverage. And Texas, which is the second largest state by population, also has the highest rate of uninsured people in the country at 25 percent.

The governor used two primary arguments to explain his stance.

First, “both represent brazen intrusions into the sovereignty of our state,” Perry said in the letter. “In short, it essentially treats the states like subcontractors through which the federal government can control the insurance markets and pursue federal priorities rather than those of the individual states.”

And second, Perry described Medicaid as “a broken system that is already financially unsustainable.” One that “would threaten even Texas
with financial ruin,” Perry said.

Turns out this is not mere hyperbole to many Texas health-care experts, Medicaid advocates and doctors, as Texas Watchdog’s Mark Lisheron reported last year.By 2009, the Medicaid hunger in Texas had grown by nearly four times to $24.6 billion, gobbling up a little more than one in every four dollars in the state budget,” Lisheron reported. The story showed that one in six Texans receive Medicaid, the costs of which in Texas are projected to grow $3 billion every year.

Those developments occurred due to Congress passing many laws during the 1980s that expanded Medicaid coverage beyond its original scope, the story showed:

  • In 1984, Medicaid would now cover children whose low-income families did not receive direct federal cash assistance. Pregnant women and their infants would get covered.
  • In 1986, undocumented immigrants and the homeless would get emergency care through Medicaid.
  • In 1987, the federal government mandated sweeping nursing home reform.
  • In 1988, Congress passed the Medicare Catastrophic Coverage Act, an expansion of Medicaid to cover long-term care for the elderly and disabled not already covered by Medicare

The health care law raised the income requirement for Medicaid to 133 percent of poverty level -- or $30,657 for a family of four.

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Contact Mike Cronin at mike@texaswatchdog.org or 713-228-2850. Follow him on Twitter at@michaelccronin or @texaswatchdog.

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Photo of surgery via the US Department of Defense.