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Although Texas Leaders Aren't Expanding Medicaid, Enrollment Numbers Slated to Jump

Filipa Rodrigues for KUT News
On Aug. 14, 2014, ahead of the next legislative session, state senators talked about one of the most politically divisive federal programs, Medicaid.

Ahead of the next legislative session, state senators are talking about one of the most politically divisive federal programs – Medicaid. Or more specifically, how to avoid expanding Medicaid eligibility in Texas and still get more people insured.

Under the Affordable Care Act, Texas has at least two options for insuring more people. One is expanding Medicaid eligibility in Texas. The state’s Republican leadership doesn’t support that option.

State Sen. Charles Schwertner, R-Georgetown, the new chair of the Senate Health and Human Services Committee, is pushing another  option. He wants the federal government to give Texas more flexibility in Medicaid. That’s by receiving a block grant, or money that would allow Texas to come up with a different solution than enrolling more people in Medicaid. Sen. Schwertner talked about the options at a Legislative hearing Thursday.

"Rather than having another unproductive debate about those two options, my intention for this interim hearing is to start a conversation that will give us an accurate picture of who the uninsured are, what services are currently available to those individuals, and ways we can fill gaps and services in a fiscally responsible manner," he said.

Officials told lawmakers that more than 730,000 Texans have signed up for coverage through the federal health insurance marketplace, and that the state expects a quarter of a million more people on Medicaid by 2017. But State Sen. Jane Nelson, R-Flower Mound, says these numbers raise more questions than answers about what effect the federal health care law is actually having.

"I mean how many people are truly newly covered not just shifted over? Individuals losing care…And I understood when I asked the question how difficult it was going be to gather this information," she said to commissioners of the Texas Department of Insurance.

Katrina Daniel is the associate commissioner for the Texas Department of Insurance. She says it’s challenging to get one direct answer on who’s uninsured and why.   

"Part of the challenge that we’re is that we’re piecing data from various sources and there isn’t a single source of data that gives us a single snapshot of who has coverage," she says.
Texas Health and Human Services Commissioner Kyle Janek told senators that his agency is working on compiling a list of health care options for low-income Texans without insurance.

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