Healthcare - We're Paying More Than We Should

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I’m passionate about a few key issues here in the state of Texas.  One of them is the need for all Texans to have high quality healthcare.   To be more specific, ensuring our children have access to high quality healthcare, regardless of their economic position.

The state of Texas spends lot of money.  Our State Budget is approximately $130B per year.   Of that $130B, about $40B or 31% of those funds are spent on Medicaid.   Medicaid is the medical assistance program passed in 1965 to provide healthcare coverage and assistance to low income and elderly Americans.   The success of the program has been overwhelmingly positive, in that it has provided coverage for millions of Americans who might otherwise not be able to afford the care, forcing them to forego treatment or pay out-of-pocket costs for their healthcare.

A few facts about Medicare (information sourced from the American Academy of Pediatrics)

  • Medicaid is an example of Federalism working at its best.  The Medicaid program is a Federal-State program where funds are sent by the Federal government to the states based on a variety of factors.  The Federal government provides some guidelines and standards, but states are free to establish their own standards on eligibility, benefits and how they pay providers.
  • In Texas, Medicaid coverage is paid with about 57% of the dollars coming from the Federal government while the state’s share is about 43%.  
  • Medicaid is mainly focused on low income children, with about 30 million children covered nationwide through the program.  In Texas, there are about 2.7 million children currently covered through Medicaid and the associated Children’s Health Insurance Program (CHIP).
  • One of the long-term benefits of Medicaid is the fact that the sooner children are given quality healthcare, the better their lifelong health will be.  This results in down the line savings in terms of cost avoidance for more expensive treatments later, but also helps reduce loss productivity by having healthier people in the work force.
  • Medicaid expenditures are tightly controlled and, while this often results in lower payments to providers (which needs to be addressed), it is on balance a more cost-effective program than similar private insurance.

Here in Texas, with a population of 28 million people, almost 27 percent or 7.4 million people are under the age of 18.   In this state right now, there are about 2.6 million children enrolled in the Medicaid program with another 682 thousand, or 9.5%, who are eligible but not enrolled.  This is something we need to work on in Austin. We need to make sure that all children who need it have access to this program.  Efforts within the legislature to trim or tighten up Medicaid coverage should be opposed with vigor.   Cutting services to the citizens of Texas seems to be the prime directive of our current representatives.  In this case, for every $1.00 cut from Medicaid, Texas loses $1.28 dollars in Federal matching funds. 

In 2010, the landmark Affordable Care Act was passed, and with that legislation, the opportunity for states to expand Medicaid coverage to provide access to more people.  Unfortunately, due to politics, in 2015, Governor Gregg Abbott decided to forego the expansion, which would have been covered 100% by the Federal government for the first two years and then 90% thereafter through the year 2020.  The refusal by the state cost Texas billions of dollars that could have provided healthcare and long-term care for people with disabilities, and those requiring nursing care for millions of people.

It is vitally important to protect this program.  It is important to expand Medicaid as provided for by the Affordable Care Act.  We can help hundreds of thousands of additional children, people with disabilities who are low-income, and elderly folks who need nursing home care.   If I am fortunate enough to be your representative in Austin come next January, I can assure you that I will fight hard to make sure Medicaid is protected.