TX State Senator Op-Ed: Fed Up with Perry's Medicaid Grandstanding

State Senator Leticia Van De Putte wrote a great piece this weekend about Rick Perry's craven and inhumane decision to block the Medicaid expansion laid out in the Affordable Care Act. Take it away, Senator!


Fed Up with Perry's Political Grandstanding about Medicaid

By Leticia Van De Putte

In 2010, Governor Rick Perry released a book titled Fed Up, outlining his complaints against the federal government. That phrase, "fed up," went through my brain again after the Governor's latest declaration in the "Obamacare" fight, when he proclaimed that Texas will not expand its Medicaid program as called for under the Affordable Care Act (ACA).

I think the people of Texas might be getting fed up, too - fed up with political grandstanding and saber-rattling, just so politicians can position themselves as "Washington outsiders." And we're fed up with the damage that comes in the wake of these political moves - actions that will force millions to continue without insurance and put taxpayers on the hook for their medical bills, while throwing away billions of tax dollars that rightfully ought to come to Texas.

It's time to move beyond grandstanding and look at the facts of the ACA and what it will cost us if we continue to have the nation's highest rate of uninsured residents.

First off, it should be emphasized that the governor's pronouncement was not the final word on this matter - any possible expansion of Medicaid must first come through the Legislature. Thankfully, the governor backtracked on his original stance and said he would work with the Legislature.

Second, let's look at the effect on Texas consumers and taxpayers if this expansion doesn't take place: While some may find the notion of subsidizing other people's insurance distasteful, the truth is, if the working uninsured put off seeking medical care because of lack of coverage, they eventually seek it in the emergency room - resulting in greater medical complications and a much higher bill, paid with your local tax dollars and cost-shifted higher insurance premiums.

Indeed, the Texas Hospital Association responded to Perry's letter with a statement reading: "... without the Medicaid expansion, many will remain uninsured, seeking care in emergency rooms, shifting costs to the privately insured, and increasing uncompensated care to health care providers. With a strained state budget, it's hard to imagine addressing the uninsured problem in Texas without leveraging federal funds, which will now go to other states that choose to expand their Medicaid program."

Did you catch that last part? Not only will Texas taxpayers foot those emergency room bills here, but by giving up federal funding that would come with the expansion, we'll also send even more tax money to pay for expansion in other states.

If opponents of the ACA would compromise, we could keep our tax money in Texas - while state Health & Human Services Commissioner Tom Suehs estimates the expansion would cost Texas $15.6 billion over 10 years, the federal government would overwhelmingly pay the balance: 100 percent for the first three years, and then gradually dropping to a still-substantial 90 percent, for a total of more than $100 billion. Do we really want to throw away a dollar match that is better than nine-to-one?

Suehs said that expanding Medicaid would reduce our state's uninsured population from 5.9 million down to 2.9 million. That's 3 million people that could be getting an ounce of prevention in a primary care physician's office, instead of the more expensive pound of cure at the ER.

Doing things the more expensive way, while we simultaneously send our federal tax dollars out of state, just doesn't make any sense. Let's do away with the rhetoric and deal with the reality.

Senator Leticia Van de Putte (District 26, Bexar County) is a registered pharmacist.

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