AUSTIN - State lawmakers renewed efforts Thursday to find a "Texas solution" to expand health-insurance coverage for low-income residents without accepting the Medicaid expansion in President Barack Obama's signature health care law.
Social-services advocates and local officials are among those pushing for a compromise measure that gives the state more flexibility than in the law to spend the money available from the federal government to cover more residents.
On Thursday, the state Senate Health and Human Services Committee met to "start a conversation that will give us an accurate picture of who the uninsured are, what services are available to them and what we can do to help them," said chairman Charles Schwertner, R-Georgetown.
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Katrina Daniel of the Texas Department of Insurance said about 6.5 million state residents do not have health insurance, although some of those can afford insurance and have chosen not to purchase it. An estimated 1.3 million uninsured Texans earn less than the federal poverty level, leaving them in the so-called "coverage gap." The president's law assumed all states would expand Medicaid, so it left those eligible for Medicaid out of its subsidies to help poor residents buy insurance.
Caring for those and other uninsured residents is costing counties billions of dollars a year, according to a letter sent to Schwertner on Wednesday by the judges in Harris, Bexar, Dallas, Tarrant, Travis and El Paso counties.
"We write not to complain about this fiscal burden or duty, but to urge your committee to use this interim to find a Texas way forward to fund and increase access to healthcare coverage for low-wage working Texans," the judges wrote.
Anne Dunkelberg, an analyst at the liberal-leaning Center for Public Policy Priorities, noted that compromises have been struck in Arizona, Indiana, New Jersey and other states with Republican governors. Those plans have included wellness programs, sliding scale premiums based on income and benefit packages tailored to match the private market.
But others slid back into the old debate about whether to expand Medicaid.
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Phillip Martin of the liberal group Progress Texas said it didn't make sense to try to come up with another plan that would do the same thing as Medicaid expansion.
"If you're hungry and you've got Franklin's BBQ in front of you, you're going to eat it," Martin said. "You're not going to go out and make a whole new barbecue."
State Sen. Larry Taylor, R-Friendswood, interrupted advocates several times to argue specifically against Medicaid expansion and generally about relying on a plan promising money from a federal government in debt.
"I think we can find a solution," Taylor said, "but we need some flexibility."
