AUSTIN, Texas – The Texas Hospital Association has come out in support of a bill to expand health care coverage to low-income Texans that includes a request for a block grant from the federal government.

Douglas A. Matney, CEO of South Texas Health System in McAllen, is on the board of trustees for the THA.

Ted Shaw, President and CEO of the Texas Hospital Association.
Ted Shaw, President and CEO of the Texas Hospital Association.

The bill the THA likes is Senate Bill 1039, authored by state Sen. José Rodríguez, D-El Paso. The companion legislation in the House has been filed by state Rep. Garnet Coleman, D-Houston. It is House Bill 3845. Both legislators are calling their bills ‘The Texas Way.’ The legislators believe that by asking for a block grant from the federal government and by looking for an alternative to expanding Medicaid they might attract more Republican support.

Coleman points out that over a million Texas residents currently fall into a health care coverage gap because they don’t qualify for Medicaid and don’t earn enough to qualify for assistance in obtaining coverage under the Affordable Care Act.

“Texas hospitals applaud Senator Rodríguez for introducing SB 1039 to develop a Texas Way forward to increasing the number of Texans with private health insurance coverage,” said Ted Shaw, President and CEO of the THA. “The senator’s leadership on this important economic issue is to be commended. With SB 1039, more than one million low-wage working Texans could purchase private health insurance and access appropriate primary and preventive care rather than relying on hospital emergency departments for acute care.”

The THA put forward its case for a “Texas Solution” to expanding Medicaid in a policy document that lists the group’s legislative priorities the current session:

If fully implemented in Texas, the Patient Protection and Affordable Care Act would have reduced the number of uninsured in the state by providing additional health care coverage through the state Medicaid program as well as the new federally facilitated health insurance exchange known as the Health Insurance Marketplace.
In 2013, legislators opted to bypass federal funding that would have covered more of Texas’ working poor families through Medicaid. The federal government would have fully funded the services these newly eligible individuals received for the first three years, with the federal government’s share eventually reducing to 90 percent over the next 10 years.
Texas will now be home to more than one million of the nation’s seven million individuals who could qualify for Medicaid. These families, who are largely employed and considered the state’s population of working poor, typically have no access to health insurance through an employer.
Although these families are left without good access to care, their health care needs will continue, as will their reliance on hospitals to provide care ranging from primary care to critical care.
Because the federal government would fund the vast majority of the costs of expanding Medicaid, studies show that Medicaid expansion in Texas would have resulted in $100.1 billion in federal revenue over 10 years while the state’s contribution would have been a fraction of that amount at $15.5 billion.
In the next two years, the costs of services provided to these otherwise qualifying patients would have been federally funded at 100 percent. Between 2014 and 2016, $614 million from Texas could result in $15.9 billion in federal funds. According to the Texas Health and Human Services Commission, covering the newly eligible would require $8.25 million from Texas to receive $78.9 billion from the federal government from 2017 to 2023.

Sen. Rodríguez said “The Texas Way” legislation would provide access to private health insurance so that low-wage working Texans can access primary and preventive care rather than relying on hospital emergency departments for acute care. He said it would also provide a transparent process to assess the impact of reduced uncompensated care costs on local property taxes that currently pay for about $1 billion of indigent health care services. Employers and those who purchase private health insurance will also benefit, the senator stated.

“Access to health care is a very important issue for my constituents in El Paso and Far West Texas, and for millions of Texans statewide. During the past year, the Senate Hispanic Caucus held six regional summits across the state. We heard over and over from hard-working Texas families that access to affordable health care is a huge priority, and more than that, a necessity. That’s why I filed SB 1039,” Rodríguez said.

One of the six regional summits was held at South Texas College in Weslaco last November. There was strong support at the summit for expanding Medicaid to help the one million Texans in the so-called “black hole” or “coverage gap.”

Rodríguez said Texas has the highest uninsured rate in the nation, with nearly one in four (six million) Texans who lack health insurance. Among these are one million Texans, Rodríguez pointed out. He said most of these are working and earning a paycheck, but their jobs either do not offer health insurance as an employment benefit or it’s offered at a price too high for low-wage earners.

Rodríguez offered these bullet points on The Texas Way:

·         Aggressively manage chronic diseases;
·         Require personal accountability for health and wellness;
·         Create a coverage option through small-employer subsidies to encourage Texas small businesses to offer health insurance as an employee benefit;
·         Create a transparent local process to evaluate the potential reduction in property tax burden;
·         Subsidize coverage in the private market based on an individual’s ability to pay;
·         Require health savings accounts and/or point-of- service cost-sharing for individuals to incentivize the appropriate use of medical care and wellness;
·         Include incentives to work; and
·         Impose financial penalties for inappropriate use of hospital ERs for non-emergent care.

Rep. Coleman said that if HB 3845 is adopted, it would mark the first time a state has formally requested a block grant under the 1115 waiver process.

State Rep. Garnet Coleman, D-Houston.
State Rep. Garnet Coleman, D-Houston.

“Texas has unique needs, needs that merit finding a distinctly Texan solution to closing the coverage gap for our most vulnerable residents,” Coleman said, in a news release issued on Friday. “While other states are finding ways to expand coverage to those who need it, we have yet to provide the federal government with a plan they can even respond to. We should explore all options – including a block grant – that would finally allow uninsured Texans to purchase health insurance. We have the highest rate of uninsured and the highest number of uninsured children. It’s time to start that conversation.”

Coleman said The Texas Way legislation addresses conservative concerns about expanding coverage by “providing the state with flexibility to tailor the program to encourage personal responsibility by beneficiaries with such provisions as premium sharing.” He said it includes stipulations to “reduce the cost of emergency room care, to protect Texans currently insured from potentially losing their federal tax credits, and more effectively use the state’s healthcare resources.”

Coleman said his proposal comes on the heels of coverage expansion plans in Republican-controlled states like Indiana, Arkansas, Pennsylvania, and Michigan.

Editor’s Note: The main picture with this story is of state Sen. José Rodríguez, D-El Paso, speaking at a Senate Hispanic Caucus summit held at South Texas College in Weslaco last November. At the summit Rodríguez discussed expanding health care coverage for the one million Texans currently without health insurance.