SAN JUAN, February 26 - I am haunted by a hearing the Hidalgo County Medical Society had a few years ago when health care reform was first being discussed.

A middle-aged woman stood up and told us how she and her husband were transferred to Texas from California. In California she was covered for health insurance under Cal-Care. She had breast cancer and was treated there. Her husband’s job here did not offer health insurance.

A few months after she moved here, she found a lump on her breast and had to find $250 to visit a surgeon, another $250 for a biopsy, all money she did not have. The lump was another malignancy. She asked where she should go. Not one of the physicians on the panel offered her consolation or assistance. She came up to me in the parking lot and asked me if I knew of any resources for her. I did not. I did not know what to tell her. Her encounter with me broke my heart. There was part of me that wished I had not heard her story and had not met her. I felt so helpless, but not even a bit as helpless as her eyes and voice indicated. I don’t know what happened to her and pray for her every night. Adult Medicaid would help her.

The Affordable Care Act includes provisions that would have offered this woman-hardworking, U.S. citizen the care she sought. This provision, Adult Medicaid, otherwise known as expanded Medicaid, would cover all adults, male and female, who make 138 percent of poverty, from the age of 19-64. If you know anyone who has two children or more and who makes $14.00 or less and hour they would have health insurance under this program.

Amazingly, our Governor refuses to participate in the program. His claim is that Texas cannot afford the costs - even though the Federal Government will pay 100 percent of the costs for the first three years and then 90 percent of the costs afterward. Hidalgo County would gain more than $400 million in Medicaid funds each of the first three years. Ray Perryman, a conservative Republican economist, agrees that it would be foolish for Texas to refuse to participate.

Just this last November a young adult from Weslaco was featured on TV asking for help. He had been a football player at Weslaco High School, and now was 23 years old. He had found out he had sarcoma of the bone and needed his leg amputated. He needed to come up with $20,000 for the surgery. He was having BBQs to try to raise money. Adult Medicaid would help him.

Because the some 42 percent of Hidalgo County residents have no insurance or are under-insured, there is no place for them to go for specialized care and hospital treatment. They used to go to Galveston, but that door is no longer open to them. Indigent health care for the County only covers people at 25 percetn of poverty.  If you have a relatively simple problem like a hernia, emergency departments do not consider that an emergency. You can’t see a surgeon. You can’t schedule a minor surgery to fix your hernia. You need to wait until you have a more serious situation, a strangulated hernia, then go to the ER and you will get treatment then, which is far most costly and you are far more ill. Ultimately in the end, we with insurance will pay for it in higher hospital costs. And, unbeknownst to some, having cancer is not considered an emergency.

Expanded Medicaid (Adult Medicaid) would make life so much easier for the more than 50,000 young adults, parents and workers in our community who are presently uninsured. I am sure that we all want healthy parents and a healthy workforce. We need to let Governor Perry understand this - and we need to let our representatives in Austin know that they need to push this message to the Governor. The effort to call your representative, and to contact the Governor’s office, will take a bit of your time to do, I know. But we do have the time. I am not sure that the mother with breast cancer or the young man with sarcoma have the time. Please, for their sake-for all of our sakes, take the time to make that call.

Ann Williams Cass is executive director of Proyecto Azteca and coordinator of the Equal Voice Network's Hidalgo County Health Working Group.