AUSTIN, Texas — Pointing to this past week’s historic Democratic-led bipartisan actions to make healthcare accessible in North Carolina, today, the Dallas Morning News editorial board published a piece calling for Medicaid expansion in Texas, writing that “Republican leadership in Austin should look to the positive experiences of conservative states that have embraced Medicaid expansion, not to mention the will of the roughly two-thirds of Texans who polls show favor expansion.”
In the editorial, the board specifically notes that “[a]s provisions that kept low-income residents on Medicaid rolls during the pandemic end, low-income Texans soon could find themselves in a health care crisis,” but that “Texas lawmakers remain stunningly unresponsive to this cliff.”
Conservative states that once opposed Medicaid expansion are reversing course to expand health coverage to more low-income residents. Last week, North Carolina became the 40th state to expand Medicaid coverage, leaving Texas among just 10 states that have not done so.
That’s right. North Carolina, a red state that voted for the Republican candidate in all but one presidential election since 1980, went from opposing medicaid expansion to passing it with bipartisan support.
Texas has dug in on the wrong side of this issue, and GOP leadership in Austin shows no inclination to expand coverage this year.
As provisions that kept low-income residents on Medicaid rolls during the pandemic end, low-income Texans soon could find themselves in a health care crisis. Many who will lose eligibility may not qualify for state programs or otherwise find health care that they can afford. Coupled with stringent eligibility rules and opposition to Medicaid expansion, Texas will continue to lead the nation in uninsured residents.
Texas lawmakers remain stunningly unresponsive to this cliff. The Affordable Care Act has sharply reduced the number of uninsured Americans by providing affordable coverage options through the Health Insurance Marketplaces and expanded subsidies to states that expand Medicaid coverage to more low-income adults.
States that expanded insurance coverage to more low-income residents received reimbursement for 90% of their Medicaid expenditures for the first two years. However, by not expanding coverage, Texas has given up as much as $5.4 billion a year in subsidies while leaving millions of low-income residents in a coverage gap. Many low-wage Texans do not receive insurance through their employers, make too much money to qualify for Medicaid or don’t earn enough to afford full-priced health insurance.
Republican leadership in Austin should look to the positive experiences of conservative states that have embraced Medicaid expansion, not to mention the will of the roughly two-thirds of Texans who polls show favor expansion. In general, conservative states that have embraced expansion have reduced uninsured health care costs that get passed along to businesses and taxpayers. They have also created new jobs and improved health outcomes for their poorest residents.
Before North Carolina’s legislature stepped up, South Dakota, another red state, last year became the 39th state to approve expansion through a citizen ballot measure that overrode the opposition of the state’s GOP governor and legislature. The Texas Constitution does not permit such ballot-led initiatives here.
The sole bright spot in Texas this session comes from bipartisan momentum for extending Medicaid coverage for moms to cover a full 12 months after pregnancy. But as long as GOP leadership turns a blind eye to the broader benefits of full Medicaid expansion, the number and rate of uninsured Texas will continue to increase.
