Republicans in Congress are pushing yet another plan to repeal the Affordable Care Act, and Texas, at first glance, looks like one of the big beneficiaries in the short term.
The new bill, known as Graham-Cassidy, would completely shake up how the federal government allocates money to states to cover health care. The money would come to states as block grants, allowing lawmakers to spend it on health care however they choose.
Texas would get a windfall of $35 billion under the plan, according to Avalere, a nonpartisan health care consulting group.
That money would replace current programs created under the Affordable Care Act, including the Obamacare marketplace here, which is how more than 1.2 million Texans get insurance now.
Stacey Pogue, an analyst with the left-leaning Center for Public Policy Priorities, said she’s concerned that additional money will not improve health care for low- and middle-income Texans.
Texas doesn’t really have the infrastructure to distribute the money, she said, blaming that on a lack of interest from Texas officials.
“We were always way behind the curve in looking at options and trying to find innovative state options," Pogue said. "It … just simply wasn’t a priority in the state."
Those priorities will have to change if the state wants to keep that money and use it to provide health care, she said.
Under Graham-Cassidy, Texas would have until 2020 to come up with a system to replace the federal marketplace.
“It would be an enormous amount of work to create affordable coverage programs from scratch in that amount of time,” Pogue said. "I don’t know that there's the political will to ensure that low- and moderate-income Texans continue to get coverage that's at least as good and at least as affordable as they do today.”
Pogue said if Texas officials don’t manage to create infrastructure in time, people will lose coverage.
Graham-Cassidy also puts hard limits on how much money the federal government gives states for each person in Medicaid. In Texas, that's mostly children.
“This results in extraordinary, draconian cuts to the Medicaid program for Texas over time,” said Stacy Wilson, president of the Children’s Hospital Association of Texas.
Wilson said children in the program will see a 31 percent decrease in funding for their health care under this plan.
“Which means for our hospitals – whose patients are anywhere from 50 to 80 percent of the people that they see – those are going to be huge, huge unsustainable funding cuts for them,” she said.
Both Wilson and Pogue also said they are also concerned the bill doesn’t have any funding assured after 2027.
