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Texas Braces for Medicaid Status Quo

John Commins, for HealthLeaders Media, June 5, 2013

"Certainly folks are concerned about the level of uninsured. They are concerned about the cost of healthcare. They understand the cost shift to taxpayers and the private market. There is a lot of discussion about it, but the general political headwind in this state against Obamacare is difficult to overcome," he says.

Perhaps the best hope for states that are ideological entrenched against Obamacare lies with the so-called Arkansas Medicaid Model, which would use Medicaid expansion money to subsidize premiums for commercial plans purchased through health insurance exchanges. That proposal is still being vetted by the Centers for Medicare & Medicaid Services.

It's not clear if Texas would adopt a similar plan. Even if it did it's not clear if the state could expand its rolls by Jan. 1, 2014 deadline.  

Hawkins remains optimistic that some sort of solution will be reached.

"Actually, in retrospect, we are pleased the debate got as far as it did where we were actually talking about alternatives because early on it looked like folks were being reticent even to have that discussion given the will of the leadership," he says. "But we did advance the discussion even to the point where if things in other states continue to move forward we may have a chance to revisit this administratively."  


John Commins is a senior editor with HealthLeaders Media.

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6 comments on "Texas Braces for Medicaid Status Quo"


Thomas Dodson (6/7/2013 at 1:26 PM)
How can Texas, or any other state for that matter, pass on billions of funds designed to help the most vulnerable among us? Short-sighted leadership is an understatement when describing their leadership.

Phyllis Kritek (6/6/2013 at 1:15 PM)
It is at least worth noting here that while arguments proceed shaped by politically motivated ideological purity or economic self interest "the least among" Texas citizens will suffer from lack of health care. The chronicling of challenges ACA presents might be energy better invested in creative problem solving. Some states are doing just that.

Pete Kelley, MD (6/6/2013 at 12:13 AM)
The carrot and stick at the same time. Medicaid expansion is not the answer. As a pediatric surgeon, I have witnessed the financial impact of Medicaid expansion first hand, through the SCHIP's program. Not only do the uninsured get enrolled, but a number of previously insured patients also convert to Medicaid. In Tennessee, we no longer have "self-pay", uninsured children, however, 65% of the children in the state are now covered by TennCare. The reimbursement rates are significantly below Medicare rates, and the system is run by Medicaid MCO's who make a huge profit by throwing up administrative hurdles and denying claims. The financial impact on pediatric specialists has been incapacitating. The hospitals are doing okay, but the doctors are getting destroyed.