Texas Refuses Medicaid Expansion - & Hospitals May Close

(This image is from the website theexpertinstitute.com.)

Texas leads the nation in both the number and percentage of uninsured citizens (with more than a quarter of the state's population being uninsured) -- and about 2 million of those people are poor people, who cannot afford to buy insurance. This has always caused a problem for hospitals, since these people clog up emergency rooms when they get sick. They have to do that since they cannot afford preventative care at a doctor's office.

But the problem goes further than overcrowded emergency rooms. While hospitals have to treat these people, they do not get paid for that treatment. To cover the costs, public hospitals need more city and county tax money -- and all hospitals must raise their prices for other patients (which just increases the number of people who cannot afford care). It was a real problem that had many hospitals in financial trouble.

Right after the passage of the Affordable Care Act, the federal government came to the rescue. They agreed to give Texas about $4 billion dollars a year for five years to help defray the cost of free care being given by hospitals through their emergency rooms. The thought at the time was that Texas would expand Medicaid in that five-year period -- giving poor people insurance so they could pay for both preventative care and hospital care (and removing the need for hospitals to provide free emergency room care).

But then the Supreme Court decided that states did not have to expand Medicaid -- and Texas Republicans decided not to do it. It was a political decision, ignoring the needs of the poor in Texas, designed to please the teabagger base of the Texas GOP. But that move was not only heartless, it was also short-sighted -- since the federal money is about to end.

The federal money (about $4 billion a year) to help subsidize free emergency room care will end at the end of next year. And the federal government has notified the state of Texas that there will not be a renewal of that agreement. Washington sees no reason to keep giving Texas this free money since the state refuses to expand Medicaid -- which would give those patients both preventative and hospital care, and remove the need for hospitals to cover the cost of that care.

The federal government is right. They should stop giving the money. There is no legitimate reason for the state to refuse to expand Medicaid (since the federal government would pay all of the costs of that expansion at first, and 90% after that). Continuing the free money would just allow the state to continue playing political games with the Affordable Care Act, while denying badly needed preventative care to the poor (resulting in unnecessary deaths, since by the time these people are sick enough to go to the emergency room, it is too late to treat some of their diseases).

The Republican governor and legislature has the legal right to refuse to expand Medicaid. The Supreme Court gave them that right. But they do not have the right to keep getting federal money by refusing that expansion. It is time for the Texas Republican-dominated legislature to stop playing political games on the backs of the state's poor people, and expand Medicaid. If they don't, the hospitals will be back in the same financial trouble they were in several years ago -- and many of them will have to close their doors (hurting not only the poor, but everyone in those communities).

I think the lives of Texas citizens, and their access to a quality community hospital, is far too important to continue refusing Medicaid expansion. Unfortunately, Texas Republican legislators think getting teabagger votes is more important -- and that is shameful.