The Texas Tribune reports that while arguments about expanding Medicaid "confound" conservatives,
two legislators think it might happen if the federal government is willing to deal:
In a statement on Wednesday, Gov. Rick Perry reiterated his stance
on the expansion, saying it would be “irresponsible to add more Texans
and dump more taxpayer dollars into an unsustainable system.”
State Sen. Jane Nelson, R-Flower Mound, has a slightly softer stance.
“I’m opposed to any expansion of Medicaid that doesn’t give Texas the
flexibility that we want,” said Nelson, chairwoman of the Senate Health
and Human Services Committee.
She remains a fierce critic of federal health care reform. “But if we
could design a program that we could live with, I would suggest we take
it to the federal government and say, you know, consider this,” she
said.
Florida asked for and received a waiver to run its program a little
differently, meaning Texas could also likely negotiate an expansion.
What would Texas want out of those negotiations? It could be getting
Medicaid money sent in a block grant that the state would use as it
chooses. The federal government has so far not been interested in
allowing that approach.
Nelson says block grants aren’t a requirement and that there are other ways Texas could tailor its
expansion.
“Co-pays, for example, to make sure people have some skin in the
game,” she said. “Making sure that our emergency rooms get unclogged.
There are a lot of things.”
State Rep. Garnet Coleman, D-Houston, says he’s working with House colleagues to figure out a compromise.
He says co-pays could work, as long as the people in Medicaid now —
the very poor, the elderly and children — don’t have to pay for a
doctor’s visit in the future. But he points out that whatever program is
offered to Washington will need to pass muster with Texas
conservatives.
“It has to be put together in such a way that the majority of this
Legislature is satisfied that there are enough conservative principles
in the expansion so that they satisfy their constituents,” Coleman said.
