Can Texas Insure More Low-Income People Without Expanding Medicaid?

Jan 6, 2015

Texas has the highest rate of uninsured people in the nation, and last legislative session, lawmakers did have some discussion on how Texas could draw down federal dollars to insure more people, but only if the options don't include expanding Medicaid under the Affordable Care Act.

At least one of the bills filed already would allow Medicaid expansion, but that doesn’t mean any will make it to the floor of the House or Senate for discussion.

Still, Gov.-elect Greg Abbott says he expects lawmakers will consider ways to reduce the rate of the uninsured, which is more than 22 percent of the state’s population.

"I am confident that the Legislature will look at a variety of different issues where we can insure that we improve health care in this state," Abbott said at a December press conference. "I’ll be happy to visit with the Legislature as we work through that process."

State Rep. Trey Martinez Fischer, D-San Antonio, has filed an expansion bill that would allow the Texas Health and Human Services Commission to accept federal matching funds to get more low-income people on Medicaid.

More than 25 states have done that under the Affordable Care Act, although the Republican controlled Legislature isn't likely to follow. We might hear lawmakers bring back discussion of a so-called “Texas solution," however, which draws down federal dollars to insure more people without putting them on Medicaid.