Expand care for Texans; keep ER for emergencies

Emergency room care is not cheap.

ERs provide some of the most expensive medical care available in our community, and rightly so. Having the best facilities, equipment and medical staff available to treat heart attacks, strokes and serious injuries can be a matter of life or death. Yet for generations, many people without insurance, who forgo preventive care and allow minor medical issues to become serious health concerns, have used the emergency room for routine medical care. Broke and with no place else to go, they view it as their only option.

It should never have to be this way — which is why we have consistently called for Medicaid expansion. So it’s encouraging to see efforts being made to change this behavior by providing health care options.

The University Health board of directors’ recent vote to allocate an extra $300,000 a year to reduce unnecessary emergency room visits and provide better access to health care for people experiencing homelessness or facing mental health challenges is a small step in the right direction. Bexar County’s public health district will contribute $1.9 million of next year’s budget of $6.2 million to the Southwest Texas Crisis Collaborative, a division of the Southwest Texas Regional Advisory Council, or STRAC, Express-News reporter Laura Garcia recently outlined.

The Methodist Healthcare System, Baptist Health System, Christus Santa Rosa Health System and Southwest General Hospital also will share in the cost. Two nonprofits, Tenet Healthcare Foundation, which is affiliated with the Baptist system, and Methodist Healthcare Ministries, are also part of the program.

The pooled funds will provide psychiatric beds to stabilize patients in crisis and direct medically stable patients to appropriate behavioral health facilities rather than having them end up in jail, the Express-News reports.

It a worthwhile investment. Think of the tragedy of Janice Dotson Stephens, a grandmother with schizophrenia who languished in jail for months on a misdemeanor charge before dying there in 2018. This would have helped her.

Local hospitals provide $1.5 billion a year in health care to a population that would benefit from safety-net programs, according to a recent study from the consulting firm Capital Healthcare Planning. Approximately $234 million of that care goes to the homeless and those in need of mental health services.

The number of uninsured Texans is staggering. In 2018, approximately 17.7 percent of the population had no insurance — twice the national average. Those numbers are expected to be higher for 2020 with more unemployment and the loss of job-related medical benefits.

Texas remains one of only 12 states that did not expand Medicaid under the Affordable Care Act. It’s way past time to rethink that.

A recent study from the Bush School of Government & Public Service at Texas A&M University projects the state would receive $5.41 billion more in federal dollars through Medicaid expansion and enroll about 954,000 of the 1.2 million who are estimated to be newly eligible under the program. State lawmakers need to make Medicaid an issue when they convene in January.

Two Republicans from Bexar County — state Reps. Steve Allison and Lyle Larson — have called for consideration of Medicaid expansion.

“As we prepare to commence the 87th legislative session and address the budget shortfall created by the pandemic, we should seriously consider accessing federal Medicaid funding,” Larson posted on Facebook. “Texas is losing out on $5.4 billion while 38 other states are taking the federal dollars. This is money we’re sending to the federal government and not getting back.”

He also points out six red states have expanded Medicaid during the past three years, but red or blue is beside the point. It’s a smart policy that would improve lives.

We hope — it springs eternal, after all — Larson’s colleagues in the Texas House are listening and doing the math.

Texas Reps. Lyle Larson, top, and Steve Allison, both of San Antonio, are calling for the Legislature to consider Medicaid expansion. Let’s hope their colleagues also see what the state and its residents have to gain.