Athens Review, Athens, Texas

December 20, 2013

Sebelius hopeful for Medicaid expansion in Texas

Associated Press
The Athens Review

HOUSTON —

Health and Human Services Secretary Kathleen Sebelius said Friday she remains hopeful Texas will expand Medicaid coverage as part of the implementation of the Affordable Care Act.

But Democratic lawmakers who joined Sebelius in Houston to promote the health care law's rollout said they expect Texas will continue to reject expansion and fight the law's implementation in general, including through a proposal for new rules for "navigators" — workers trained to walk people through the enrollment process for insurance.

"Texas has largest number of uninsured in the country," Sebelius said. "Absent Medicaid expansion, there will still be millions of Texans that will not have affordable options for themselves and their families."

The state's GOP-controlled Legislature opted not to create a state-run insurance marketplace, and Republican Gov. Rick Perry also declined to expand Medicaid to cover more of the working poor.

About 14,000 Texans enrolled for insurance coverage in October and November on the federal online exchange. Coverage under these new insurance policies was to begin Jan. 1. Texas has about 6 million people who are uninsured.

Sebelius said her agency intends to continue discussing Medicaid expansion with Texas leaders. But she did not specify if there are any ongoing efforts on that front.

"This is more empty rhetoric from the Obama Administration," said Lucy Nashed, a spokeswoman for Perry, in a written statement. "The governor and Texas lawmakers have been clear that we are not interested in expanding Medicaid. If the secretary was interested in working with Texas, she would grant us the flexibility we need to implement meaningful reforms to our existing Medicaid program, rather than forcing more people into a failing system."

Perry directed the Texas Department of Insurance earlier this year to implement rules for navigators that he said would protect Texans, including requiring the workers to complete an additional 40 hours of state training, pass more exams and submit to regular background checks while on the job.

Some lawmakers and supporters of the Affordable Care Act have said the new rules for navigators are obstacles designed to fight the rollout of the health care law.

Dozens of supporters of the health care law and nonprofits trained to help Texans purchase coverage packed a state meeting room in Austin on Friday and urged the insurance department to reject additional navigator oversight.

The United Way of Tarrant County, which received a $5.8 million federal grant to build a navigator network, would potentially need another $145,000 to meet the additional state requirements, said Tim McKinney, the group's president and CEO.

Republican state Rep. Kenneth Sheets supports the new rules, saying additional oversight is needed to protect consumers from fraud while enrolling.

Sheets said he's not worried about the extra stress new requirements might put on navigators, who he says are currently unqualified and could act as political operatives.

The agency could make its decision on the proposed rules as early as Jan. 7. The rules are supposed to be in place by March 1.

"Texas has tried every way they can to hurt the expansion of people getting insurance," said U.S. Rep. Gene Green, D-Houston. "I don't understand why the state wouldn't want to have Texans covered by health insurance. But, then, that's the governor's decision."