In Dallas, Obama urges Medicaid expansion as he scoops up cash

by Todd Gillman

Source: Dallas Morning News

In Dallas to raise cash for Senate candidates, President Barack Obama took a side trip Wednesday to pressure Gov. Rick Perry to expand Medicaid and thank volunteers working to help uninsured Texans.

He called it a "no-brainer" that Texas could provide coverage immediately to 1 million working poor for little state investment -- if only Perry would go along.

"I know that sometimes this task is especially challenging here in the great Lone Star State," he said at Temple Emanu-El. About 150 volunteers, many with Dallas Area Interfaith, gathered there to share encouragement with a president whose signature health care law has suffered a disastrous rollout in the last month.

But "there's no state that actually needs this more than Texas," Obama added.

Perry called the visit a "desperate attempt to salvage his ill-conceived and unpopular program."

"Texans aren't the reason Obamacare is crumbling," the Republican governor said in a written statement. "Obamacare is the reason Obamacare is crumbling."

The visit came as the administration makes a big damage-control push on the debut of the Affordable Care Act's health insurance marketplaces. Democratic senators, concerned about next year's midterm elections, met with Obama before he left the White House to discuss the law's implementation.

And on Capitol Hill, lawmakers grilled Health and Human Services Secretary Kathleen Sebelius, with repeated calls for her resignation.

Texas has been one of the chief sources of resistance to the health care law. The state is one of 25 that have refused to expand Medicaid, the state-federal program originally aimed at providing health care to the poor. Nine GOP governors have agreed to expansions, and Obama's visit seemed intended to shame Perry into joining them.

Texas has 6.4 million uninsured residents, about 1 in 4 overall. Dallas County alone has at least 650,000 uninsured residents, or 28 percent of the population.

Expanding Medicaid would provide coverage to more than 1.5 million Texans. Perry warns that the federal government probably will shift more of the cost to states in coming years, and Medicaid already consumes a quarter of the state budget, he noted.

Obama didn't mention Perry or other state leaders by name, though later, at his first fundraiser, he called their resistance to Medicaid expansion "bullheadedness."

He also made several allusions to Sen. Ted Cruz, the Texas freshman who pushed for a government shutdown in a failed effort to demand funding be stripped from the health law.

"Right now there's a group that -- and a few of them are from Texas -- who just aren't willing to do the hard work and compromise necessary to move the country forward," he said of congressional Republicans.

Obama attended two fundraisers at the homes of two top Democratic donors. The first was a $15,000-per-person reception hosted by lawyer Peter Kraus, the second a $32,400-per-person dinner at the home of Russell Budd. The events raised millions of dollars for Democratic Senate campaigns; the party faces several uphill battles to keep seats in Republican-leaning states next year.

After just a few hours, the president was headed back to Washington. His quick sweep through a busy part of town at rush hour created extensive traffic snarls that even caught up one of his most prominent Texas friends -- Ron Kirk, the former Dallas mayor who was Obama's trade ambassador in his first term.

Dallas' importance

Success in areas like Dallas is important to the health care law, said John Goodman, president of the National Center for Policy Analysis, a Dallas-based conservative group.

"If they make it really, really difficult to sign up, the only people who sign up are people with a really strong interest in getting insurance," Goodman said, meaning those who face high health care costs. That could raise costs for all and make it even less enticing.

"The president has some explaining to do," Goodman said. "He said over and over again that people could keep their insurance if they liked it."

At Temple Emanu-El, the president met with navigators hired by the Community Council of Greater Dallas to help people enroll through the troubled site.

He also thanked volunteers from Dallas Area Interfaith. The coalition of religious and other groups is working to spread the word about the new marketplace, raising $100,000 to distribute 30,000 pamphlets educating local residents about their options.

Obama was joined by Dallas Mayor Mike Rawlings and County Judge Clay Jenkins, whom he singled out for working to implement the law. Volunteers pitched success stories about signing up needy Texans so far.

"This is the most comprehensive community effort in the country, and it's happening in the reddest state," said Jenkins, a former Obama campaign lawyer.

Joyce Campbell with Be Covered Texas, a grass-roots education campaign that launched in March, said her group has 66 partners in Dallas working on enrollment events and other outreach.

The president's visit will inspire the effort, despite frustrations over the balky website that has stymied so many enrollees.

"He was coming in like the head coach saying, 'We've got a good game going, we now need to move the ball to the goal line,'" she said.

Outside, a handful of protesters greeted the president, railing against the health care law. They carried signs reading "Lies Lies Lies" and "Honk if you want Obama impeached."

Uninsured problem

Aboard Air Force One heading to Dallas Love Field, White House press secretary Jay Carney said the president chose Dallas to talk about Obamacare because it's one of the top 10 cities in terms of uninsured Americans.

He noted that about 550,000 of the uninsured in North Texas have incomes below 138 percent of the federal poverty line, which means they get no benefit of the law because of the state's refusal to expand Medicaid.

In Texas, Democrats and advocates for the poor have denounced Perry and the Legislature for deciding against Medicaid expansion this year. So do hospitals and business groups. They argue that for an investment of roughly $15.6 billion in the next 10 years, Texas would reap $100 billion in federal funds and make major strides in reducing the number of uninsured residents.

Indigent care costs Texas hospitals $5.5 billion per year. In Dallas alone, the figure is $1 billion. Texas insurance customers pay $1,800 extra per year on average for premiums due to the size of the uninsured problem, and Texans pay more than $1 billion in local taxes statewide.

Carney insisted that the president's trip isn't any sort of effort to shift focus from rollout problems.

"I can promise you that whether or not the website worked we would be going to places like Dallas, where the education effort and outreach effort is underway, to reach these dense pockets of uninsured Americans," he said.