I wrote the email below over the weekend. This morning, we learned that Governor Rick Perry is making the shortsighted and ill-informed decision to not pursue Medicaid expansion or set up a state insurance exchange under the Affordable Care Act. The governor’s announcement is about politics, nothing more, and will only serve to lengthen Texas’ unfortunate reign as the state with the highest rate of uninsured. I’ll have more to say on his announcement later, but for now I wanted to share my original email, and why it’s so important that Texas get this right.
Campaigns are generally not known for enhancing healthy lifestyles. You tend to eat a lot of fast food, and the hectic pace crowds out one’s time at the gym. At least that’s been my experience. Having recovered somewhat from a long campaign, I dragged myself to the gym early this morning for the first time in a few months. And while it wasn’t easy getting up at 5:00 am to go to the gym, I take some solace knowing that by having a plan and some discipline in exercise and diet, I can lose the few (OK, several) pounds I gained the last few months, feel better and be healthier. Short term pain, long term gain, as they say.
Just like I need to have a plan and some discipline to get healthier, so does Texas. With the highest rate of uninsured in the nation and a troubling new study out last week that showed Texas ranks dead last among the 50 states in health care delivery, there’s no shortage of improvements to be made. But here’s the good news: just like I have tools to get healthier (a gym, a running trail nearby and better food choices), so does Texas – it’s called the Affordable Care Act (ACA), recently upheld by the Supreme Court. But just like my gym membership that’s worthless when it goes unused, Texas must use the ACA smartly to get the maximum benefit for our state. Here’s how:
Set up an insurance exchange. The ACA calls for setting up an insurance exchange in each state so that folks without employer-based coverage can shop for plans (this is not dissimilar to the way we buy electricity for our homes in Texas). If the state does not set up an exchange, the federal government will do it for us. It should be a no-brainer that we would set up our own system, instead of having a “one size fits all” set up by the feds. But since Texas Republican leaders killed efforts to set up an exchange last year, that is exactly what will happen unless we reverse course and get it together, fast.
Accept the Medicaid expansion. This is the big one for Texas – with the highest rate of uninsured in the nation, we have the most to gain from this. Under ACA, states can enroll their citizens in Medicaid if their annual income is 133 percent of the poverty level (about $30,000 for a family of four) or less. We could insure about 1.5 million people in Texas under this provision.
And what would that cost the state of Texas? For the first couple of years, the federal government funds the entire expansion. Eventually, Texas would be responsible for paying 10 percent of the cost. A 9:1 match is hard to beat – and it would be an outrage for Texas not to claim its fair share of funding under the law, especially when our need is so great.
I am looking forward to serving in the Legislature next year, and working with fellow lawmakers to make the ACA work for Texas. If we identify the problem (the uninsured/poor access to care), set some goals (reduce the rate of uninsured/improve access), develop a plan (implement the ACA) and have some discipline (focus on reform, not false rhetoric about socialism and government takeovers of health care) we’ll make a real difference in the quality of life for millions of Texans. And by reducing the ranks of the uninsured, we can drive down premiums for everyone else. After all, we’re already subsidizing emergency care for the uninsured with high premiums and tax support for public hospitals.
To lose weight, I have to follow a pretty simple formula: burn more calories than I consume.
To make Texas healthier, it’s nearly as simple: reduce the rate of uninsured and improve access.
Both just require some willpower – and a plan.