“Many of us are very weary of Medicaid expansion,” said state Rep. Jeff Leach, R-Plano, who offered an amendment to Senate Bill 7 that would ban Texas from expanding Medicaid eligibility without the approval of the Legislature. While House lawmakers recognize that Texas’ large number of uninsured residents is a problem, Leach said, “We don’t believe that Obamacare is the answer to that.”
Leach’s amendment — which was adopted with a vote of 87 to 57 — would prohibit the Health and Human Services Commission from providing “medical assistance to any person who would not have been eligible for that assistance and for whom federal matching funds were not available” under the state’s existing criteria for medical assistance.
State Rep. John Zerwas, R-Richmond, expressed concern that the “broad stroke” of Leach’s amendment would handicap the state’s ability to stretch federal matching dollars in other programs, such as the 1115 Medicaid waiver program.
“I’m the first to tell you that the Medicaid system is very fragile,” said Zerwas, who has pushed this session for the Legislature to weigh in on the Medicaid expansion debate by approving “a Texas alternative” based on private-market reforms. “But this particular provision, in terms of restricting any ability to utilize matching funds for the provision of health care, is not the right amendment for this bill,” he said.
But under current law, Leach said, the state health commissioner or governor could expand Medicaid coverage without legislative approval. The expansion of Medicaid eligibility is “too big of a decision for the future of this state to be made by one person, and I believe the Legislature ought to be involved,” he said.
The House sponsor of SB 7, state Rep. Richard Peña Raymond, D-Laredo, said the amendment would not directly affect SB 7. “Obviously this amendment is a bigger debate,” he said and attempted to table the measure.
State Rep. Mark Strama, D-Austin, read off a list of taxes Texas would pay to finance Medicaid expansion and other provisions in the Affordable Care Act — regardless of the state’s decision to expand Medicaid.
“If we choose not to, we will become far and away the biggest donor state to the federal government,” he said. “We will still pay the taxes required of us under the Affordable Care Act. The difference is we will pay it to provide health insurance to other states’ low-income” populations. Continue reading