Court Ruling Is Bad For The Poor In Texas

The news media is reporting that Obamacare is constitutional, and left-wingers and Democrats are celebrating across the nation. And there is much to celebrate -- students up to age of 26 will be able to stay on their parents insurance, insurance companies can no longer deny coverage because of pre-existing conditions, insurance companies cannot cap the amount of medical expenses they will pay for, insurance companies can no longer terminate coverage when a consumer contracts a serious (and expensive) illness, and insurance companies cannot charge women a higher premium than they charge men. Those are all good things, and I approve of them.

But the Supreme Court did NOT approve all of Obamacare. It left a gaping hole in the Medicaid provision of the law -- a hole that many hard-hearted Republican state administrations will use to deny health care coverage to poor people. And I expect Governor Perry and his Republican legislative cohorts to lead that charge in denying health care to the poor.

Texas already led the nation by having the largest percentage (and number) of people without any form of health insurance. At least 27% of Texans have no health insurance coverage at all. This is due to a couple of things. First, Texas also leads the nation in the percentage and number of minimum wage, no benefits jobs. Second, Texas has some of the most restrictive Medicaid rules in the nation -- rules that allow only a tiny percent of even those living in extreme poverty to qualify for coverage.

Some in the first group will now be able to get coverage, since the government will pay for some (or all) of their insurance premiums. But the court decision will allow the states to continue to deny coverage to many of the poor -- those who would have qualified for Medicaid if the entire Obamacare law had been upheld. Here is the offending portion of the Supreme Court decision:

“Nothing in our opinion precludes Congress from offering funds under the ACA to expand the availability of health care, and requiring that states accepting such funds comply with the conditions on their use. What Congress is not free to do is to penalize States that choose not to participate in that new program by taking away their existing Medicaid funding.”

That means that Texas can just refuse the "additional" Medicaid funds, and continue the current inadequate Medicaid system that it currently has. And that's exactly what I expect the Republicans controlling the Texas state government to do. They will complain that extending Medicaid to cover all of the poor would be too expensive (even though 90% of the cost would be paid by federal funds).

We already have a precedent for this kind of action from Texas Republican leadership. led by the governor, Texas turned down hundreds of millions of dollars in educational funding, simply to avoid requiring Texas schools to meet the more demanding requirements of the national educational standards. If they would do that to school children, do we really expect them to accept funds to help the poor (who they don't care about at all)?

If you're poor and live in Texas, you might as well just stay bent over -- because the screwing you've been receiving is going to be continued. As long as the Republicans remain in power in Texas, the state will continue to have the largest number of people without any kind of health insurance.  This Supreme Court decision just allowed many Texans to fall through the cracks in health care reform.