There are only a handful of moments that truly will define our career, tenure and, indeed, our life. We are in the midst of a global pandemic, and the decisions made now will define our generation of Texas leaders. 

This moment in history requires courage, flexibility and, now more than ever, the expansion of Medicaid in Texas. 

As national and state leaders grapple over when to open the country, the balance that must be struck lies in the (at times) competing interests of public health versus economic stimulus. Expanding Medicaid can accomplish both simultaneously. 

We know the numbers well: 1.5 million uninsured Texans fall into the “expansion gap”–people who could qualify for coverage with a stroke of the governor’s pen. Those 1.5 million Texans who can’t afford access to health care may put us all at risk. Yes, the federal government is offering to cover COVID-19 testing costs, but what about the costs of treatment? It is no secret the uninsured are less likely to seek medical help due to financial concerns, thus exacerbating the curve, not flattening it. 

Economists estimate that expansion would infuse approximately $8 billion annually into the Texas economy, increase gross state product by $29.4 billion over two years and generate a 331 percent return on investment over 10 years. It is too early to know the full extent of the economic devastation that COVID-19 has caused, but common sense dictates that we could use an extra $8 billion, especially now. By not expanding Medicaid, state leaders are turning away billions of our own tax dollars Texans pay to the federal government when we need it for our own priorities. 

All but 14 states have accepted and benefit from expanding Medicaid in some form, none more so than Indiana under the leadership of Vice President Mike Pence when he was its governor. He, along with many other Republican governors, saw an opportunity to improve health outcomes for their respective states, while also tailoring their unique approaches to the program. Texas should follow the same approach and tailor it to the unique needs of Texans. 

Texas continues to have the most uninsured in the nation. In 2018, for example, at 17.7 percent, Texas had more than twice the national rate. Our rural and border communities are suffering with up to 36 percent uninsured and more rural hospital closures than any other state. 

The McAllen-Edinburg region that includes Starr County, for example, has an uninsured rate of 30.6 percent. That means more than 260,000 or nearly 1 of every 3 persons do not have health insurance. This is unacceptable. It is more than numbers. These are our neighbors, family members and friends who worry every day, especially these days, “What will I do if I get injured or sick?” 

While they might be asking themselves if they can afford necessary treatment and care, we must ask ourselves, can we afford for them not to?

Our state’s revenue will take a significant hit because of the coronavirus outbreak. As we contend with the troubles of the oil industry, coupled with those caused by the pandemic, it doesn’t make sense for state leaders to refuse billions of our own federal tax dollars. The double whammy significantly will reduce the state’s ability to pay for other essential obligations and ultimately reduce our ability to afford any tax cuts. The obvious alternative? Take the billions in federal tax dollars that we pay and give them back to Texans. 

So, here we are: the aforementioned “defining moment.” Make no mistake: We are challenged with a worldwide pandemic and unprecedented times. We need leaders to make decisions that focus on the needs of our people without fear or hesitation. History has its eyes on us. It’s time to expand Medicaid.

Editor’s Note: The entire Texas Senate Democratic Caucus penned the above guest column. The group is chaired by state Sen. Carol Alvarado of Houston. The other members are Vice Chair Sen. Nathan Johnson of Dallas; Sen. Juan “Chuy” Hinojosa of McAllen; Sen. Eddie Lucio, Jr., of Brownsville, Sen. José Menéndez of San Antonio; Sen. Borris Miles of Houston; Sen. Beverly Powell of Burleson; Sen. José Rodríguez of El Paso; Sen. Royce West of Dallas; Sen. John Whitmire of Houston and Sen. Judith Zaffirini of Laredo.  Senators Zaffirini, Lucio, and Hinojosa represent different regions of the Rio Grande Valley.

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