Michael Hiltzik offered up some potentially good news at the end of this year, Is Texas, the Biggest Domino, About to Topple on Medicaid Expansion? It seems that not all right wing freaks are created equal. With Rick Perry and his Super Glasses leaving office to pursue truth, justice and the American way, governor-elect Greg Abbot has indicated that he might be open to taking the Medicaid expansion in the form that Arkansas and Utah have pioneered. In it, instead of the working poor getting added to Medicaid, they are given money to buy insurance on the exchanges. It ain’t perfect, but it is a distinct improvement on the way things are.
It’s kind of the perfect way for Republicans to dip their toes into Obamacare. After all, they are already part of it. The citizens of Texas are already required to have health insurance. And they are already paying higher taxes for the new law. So they are getting everything bad from the law and relatively little good from it. They might as well get some of that money back that they are sending away. The way the law was designed, blue states (because they are generally richer) were subsidizing red states. But because Republicans have been so spiteful about Obamacare, it’s worked out that red states have been subsidizing blue states. This is not a state of affairs that can go on for long.
This kind of “block grant” approach to the Medicaid expansion is something that Republicans have long claimed to like. And this kind of deal is a great face saving maneuver that allows the Republicans to claim both that they made the evil president bend to their will and that they don’t just hate the working poor. (Even though they clearly do.) Now we will have to see if Texas goes along with this. It is still likely that the Texas legislature will be unable to get past their mean girl spite and do what is best. But this is good news regardless.
Hiltzik runs the numbers in his article and they are overwhelming. Texas has the highest level of uninsured residents with over 22%, when the average is around 13%. And with bad economic times coming to Texas, it will only get worse. A 2013 report found that by not taking the Medicaid expansion, the state was set to lose almost $8 billion and have extra costs of almost $400 million. That was for a two year period. What’s more, hospitals are getting hit hard. Each year, they do $17 billion in uncompensated work. The Medicaid expansion would take a big chunk out of that.
I spend a lot of time complaining that the Democratic Party is too much the party of big business. But what’s remarkable is that the business community is so wedded to the Republican Party when the party doesn’t look out for its interests at all. Its general incompetence hurts business growth but on the individual level, it doesn’t do anything for business except for its trademark crony capitalism.
But we have a perfect storm here in Texas. It is losing a huge amount of money. The hospitals are keen to see the extra money coming in. The state is looking at bad times ahead. And it has a perfect face saving excuse for signing up for the program now. Given the absolute joke that the Republican Party is — especially in Texas — we can’t say what will happen. But this is hopeful news. And if Texas accepts the Medicaid expansion, many other states are sure to follow.