Athens Review, Athens, Texas

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April 23, 2013

Bill clears way for Medicaid debate in Texas House


AUSTIN, Texas (AP) — Another — and perhaps final — fight over Medicaid expansion may be on the horizon in the Texas Legislature.

Despite notable reluctance and the House instructing budget negotiators this week to not even consider voting on Medicaid proposals, a House panel on Tuesday cleared the way for the full chamber to debate drawing down millions of federal dollars to provide health care for more low-income Texas residents.

Fewer than five weeks remain in the 140-day session, and Republican state Rep. John Zerwas urged his colleagues to let his Medicaid blueprint have its day in the full House.

"We're running out of time," said Zerwas, a doctor from suburban Houston.

His measure cleared the House Appropriations Committee 15-9. It now goes to the calendars committee, which decides when bills will be taken up by the full House.

Zerwas is proposing what he calls the "Texas Solution" — and insists it is not an expansion of Medicaid. His plan calls on the federal government to issue a block grant to Texas rather than force the state to expand under the Affordable Care Act.

Texas has the highest rate of uninsured in the nation with about 6.2 million of its residents lacking health care coverage. Advocates claim extending Medicaid could provide up to 1 million Texans with some coverage.

Gov. Rick Perry has said expanding Medicaid would bankrupt the state. Conservative Republicans, meanwhile, doubled down on their opposition Monday when state Rep. Brandon Creighton, chairman of the House Republican Caucus, pushed through a measure instructing House budget negotiators to not favorably vote for any Medicaid expansion.

Medicaid is a jointly funded federal-state program. Perry said it accounts for about 25 percent of the state budget and that embracing expansion would eventually see that balloon to a third of all state expenditures.

"Texans will be shouldering an ever-increasing portion of the costs under Medicaid expansion due to the fact that the federal money is temporary," Creighton said.

Zerwas' bill would impose reforms on the existing Medicaid program by requesting a block grant and create what Zerwas describes as a non-Medicaid program that would offer low-income Texans options in the private market. That part of the plan would be contingent on Texas receiving permission to draw down federal dollars outside Medicaid expansion.

Federal officials have repeatedly rejected Texas requests for a block grant, but have preliminarily approved an Arkansas plan to use federal dollars to buy private insurance for the working poor.

"We can't do this alone," Zerwas said. "We're going to have to partner with the federal government in order to provide this level of care."


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