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House Opens Door to Medicaid Expansion Negotiations

Todd Wiseman via Texas Tribune

In the midst of debate on the 2014-15 budget, the House quietly approved an amendment on Thursday that would open the door to negotiations on expanding Medicaid, a key provision of federal health reform. The amendment requires the Health and Human Services Commission to develop a plan to create more efficient health care options for Medicaid populations if the state chooses to draw down federal financing to expand Medicaid eligibility.

"It's a step in the right direction. In the political climate we're working in, this is as good as we can get them to do," said state Rep. Lon Burnam, D-Fort Worth, the author of the amendment. “Obviously there are some members that are not enthusiastic about Obamacare, but they don't represent a district like mine.”

The amendment does not direct HHSC to expand Medicaid. It says that if the state negotiates with the Obama administration to expand eligibility, it must reach a deal that reduces uncompensated care costs, promotes the use of private insurance plans and health savings accounts, and establishes wellness, cost-sharing and pay-for-performance initiatives. It also calls for creating customized benefit plans for different Medicaid populations. The Legislative Budget Board is charged with determining if such a deal addresses those reforms.

The language is similar to a budget rider authored by Sen. Tommy Williams, R-The Woodlands, that the Senate already approved. But it differs in two ways: The House version only requires newly eligible populations to participate in cost-sharing initiatives, such as copayments or deductibles. And it directs savings realized from the reforms to the state’s other health programs.

"Today's vote moved us further away from Perry's insistence on just saying 'no' and closer to finding a responsible solution for expanding Medicaid and improving health care in our state,” said Philip Martin, the political director of Progress Texas, a liberal group that has compiled a list of 81 organizations in favor of Medicaid expansion.

Chris Hooks and Aman Batheja contributed reporting to this story. 

Becca Aaronson develops data interactives and reports for The Texas Tribune. After an internship in fall 2010, she was hired by the Tribune to help cover the 82nd legislative session. She previously interned at the Houston Chronicle. Becca is a native of Austin who graduated from Scripps College in Claremont, Calif., with a degree in cultural theory.
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