State task force releases health care report, favors Medicaid expansion

Report says increasing coverage would help 1 million, but refusing means funding other states' efforts

by Lora Hines

Source: Houston Chronicle

Texas should pursue an alternative to Medicaid expansion that maximizes private coverage for low-income residents in a way that taxpayers will support, says NCPA Senior Fellow Devon Herrick in the Houston Chronicle.

The report by the Code Red Task Force on Access to Health Care in Texas says doing so would not only cover an estimated 1 million residents but also prevent billions of dollars in federal taxes paid by Texans from going to other states to fund their programs.

The Code Red Task Force, made up of health care providers, researchers, business leaders and advisers from across the state, also proposes development of more organized local and regional health care and creation of more medical residency programs to expand the state's health care workforce to improve patient care and keep people healthier. The group will discuss its findings Wednesday at Rice University's Baker Institute.

The group's report is its fourth since it was established in 2006 by the state's 10 academic health institutions to address Texas' health care needs.

The task force has no authority to enforce its proposals. Many of its recommendations, including Medicaid expansion, would require action by the Texas Legislature.

Says cost is high

Dr. Kenneth Shine, a task force senior adviser and special adviser to the University of Texas System's chancellor, said failure to expand Medicaid will cost Texans an estimated $32 billion in federal taxes over 10 years.

"It's going to other states to expand their coverage," he said, adding that the state stands to lose billions more if other federal programs for funding health care aren't renewed.

Shine said the state's coverage gap "is real. There are 1 million or more people who don't make enough to be eligible for coverage. This needs to be addressed."

The task force report proposes a coverage solution similar to those offered by other states and other Texas organizations. Dubbed the Texas Prescription, the plan would include insurance premium subsidies, require participant contributions and encourage healthy behaviors, while discouraging unnecessary emergency room visits.

Passage of such a plan could bring in an estimated $66 billion in federal funding over 10 years, as well as about $35 billion in "secondary benefits," such as new jobs and health care savings as a result of more people gaining coverage, according to the report.

Shine said the health-care industry, government officials and business organizations, including chambers of commerce, "are in favor of Texas trying to do something. We continue to be the state with the highest rate of uninsured."

However, the task force has no plans to lobby the Legislature to push for change, said its chairman, Steve Murdock, a Rice University sociology professor.

"We are information providers," he said. "We inform whoever will listen."

Talks with lawmakers

The task force's report comes as Gov.-elect Greg Abbott reportedly met privately last month with Houston-area state lawmakers and asked for more information about a compromise recently struck by the Republican governor of Utah and the federal government that could pave the way for that heavily conservative state to expand Medicaid through the Affordable Care Act.

Twenty-seven states have accepted some form of Medicaid expansion, including eight with Republican governors.

Proposals are under discussion in seven other states, including Utah, according to the nonprofit Henry J. Kaiser Family Foundation.

Urges a private pool

State and local health care-policy experts said the task force's support of a Medicaid expansion proposal didn't surprise them. Devon Herrick, a senior fellow at the National Center for Policy Analysis, a conservative Dallas think tank, said provider groups, including the Texas Hospital Association, want to expand coverage "in any way they can."

But he warned against merely trying to cover what hospitals spend on caring for poor.

"Medicaid expansion, as originally prescribed by the Affordable Care Act, is not likely to pass in Texas," he said.

Herrick, who is releasing his own Medicaid expansion analysis Wednesday, said Texas should pursue a private insurance pool or some other means of expanding coverage in a way that residents support.

"There is a huge gap between what the incoming Texas governor and cash-strapped Texas lawmakers may be willing to do and what these stakeholders/providers actually want," he said.

Calls expansion crucial

Elena Marks, president and CEO of Houston's Episcopal Health Foundation, said Medicaid expansion is too important for Texas lawmakers to pass up, no matter how they decide to negotiate it with the federal government.

"There are a lot of pieces of plans people are putting forward," she said, adding that many include financial contributions by beneficiaries.

She said she hopes Abbott "will listen to all stakeholders."

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