Expand Medicaid
Texas’ failure to do so leaves children without care that can help them nowand in the future.
Not all our troubles can be blamed on the pandemic. Even before the novel coronavirus outbreak, the number of children living without health coverage in the United States had risen to the highest levels in more than a decade.
After reaching a historic low of 4.7 percent in 2016, the rate began to increase in 2017 before jumping to 5.7 percent in 2019, according to a new study by Georgetown University’s Center for Children and Families.
A dismal statistic — especially during the longest economic expansion in American history.
That increase translates to approximately 726,000 more children without health insurance since the beginning of the Trump administration and its efforts to dismantle the Affordable Care Act.
The numbers are even grimmer in Harris County, where 15 percent of children are without coverage, 2.5 times the national rate. The rest of Texas isn’t doing much better at 12 percent, more than twice the national number.
Behind all these numbers are real children who have little or no access to the basic care they need not only to survive the bumps and bruises of childhood, but for the kinds of medical exams and treatments that can help them avoid or manage long-term health problems later in life.
The Georgetown report estimates the three-quarters of a million additional youngsters nationwide without health insurance include about 178,000 infants, toddlers and preschoolers under the age of 6.
That is unacceptable in a wealthy nation and a state as prosperous as Texas.
This is before calculating the costs of the pandemic, which left 3.6 million Texans unemployed in October, stripping many of them of their employer-provided health insurance. More than 25.5 million Americans are out of work nationally, under similar circumstances. Georgetown’s Center for Children and Families estimates that an additional 300,000 children have become uninsured this year.
Experts suggest that the long-term answer is an overhaul of America’s health care system, something that Republicans in Congress have not been able to agree on. President Donald Trump has repeatedly promised a major retooling but has so far fallen short.
The quicker fix for Texas would be to simply take advantage of the ACA’s option of expanding Medicaid, the largely federally funded program that provides health coverage for low-income adults, children and pregnant women.
Texas is now just one of 12 states that have declined to tap into the program, which comes with 90 percent funding from the federal government for new enrollees against a 10 percent share from the state. Of those dozen refusing expansion, Texas has the highest number of uninsured residents at 5 million.
The Children’s Health Insurance Program provides low-cost or no-cost care for children whose parents make too much to qualify for Medicaid. But advocates say that red tape, fears about immigration enforcement and cutbacks in outreach have caused many children to fall off of the CHIP rolls in recent years.
Govs. Rick Perry and Greg Abbott, both Republicans, have refused to sign the state up for Medicaid expansion. Perry said the program was unsustainable, and Abbott accused the federal government of being “coercive” in trying to bring the state on board.
The GOP-controlled state House and Senate have also rejected legislative efforts to make the change. A bill would have to pass both houses and then be signed by the governor to become law.
One big difference this year may be a state budget that has been battered by the pandemic and the accompanying business shutdown.
A Medicaid expansion could bring up to $5.4 billion in federal dollars into the state and enroll nearly 1million more people in the program, according to a study by Texas A&M researchers.
“If we don’t expand Medicaid, I don’t know where we find that money,” state Rep. Sarah Davis, R-West University Place, told the editorial board. “I’m trying to tell my colleagues that we’re just leaving billions of federal dollars out there if we don’t do something.”
Davis, a rare Republican convert to expansion, admits she rode into the Legislature on the “anti-Obamacare bandwagon 10 years ago” as part of the tea party wave against the ACA.
She was a recent cancer survivor concerned about what the law would do to her access to doctors and chemotherapy in the event of a recurrence.
“To be honest, I’ve learned a lot since then,” she said. “I don’t know what the argument against expansion legitimately is, except that it has just become a partisan point.”
The argument she is trying to make to her colleagues is based primarily on the state of the budget, she said, “although I think there is a moral argument to be made, too.”
That argument should include the number of children being barred from health coverage by a decade-old partisan campaign meme that was wrong even back then.
When lawmakers reconvene in January, it is time to accept the Medicaid expansion and provide health care coverage for another million Texans, including hundreds of thousands of children.