Medicaid expansion makes dollar sense for Texas and Tarrant County

Posted Wednesday, Apr. 03, 2013  comments  Print Reprints

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The Texas state government is poised to make one of its biggest mistakes since someone decided joining the Confederacy was a brilliant idea. We may turn down a massive amount of federal funding because some Texas officials are uncomfortable with the government funding health insurance.

It is hard to overstate how good this deal is. The federal government, under "Obamacare," is offering to cover 100 percent of the health insurance costs of 1.5 million low-income Texans -- 56,000 of them in Tarrant County -- through an expansion of Medicaid. After three years, federal dollars will continue to cover about 90 percent of the costs.

This works out to roughly $100 billion in federal funding for the $15 billion we put down over the next 10 years. Over the first three years, the state economy is boosted by 231,000 jobs and $68 billion in economic activity, with $2.99 billion of that in Tarrant County.

Much of opposition to the proposal seems to stem from a misconception that Medicaid already provides a lot of healthcare for the working poor. It doesn't, at least not on a large scale.

Currently, Medicaid pretty much only covers the disabled, the births of children to poor women, children in low-income families and incredibly poor adults with children.

The most working adults can make and still receive Medicaid coverage is $6,123, and that's only if they have three children. No one without children is eligible.

An adult working full-time for minimum wage makes $15,080 a year. In the Fort Worth district I represent, the average income is $12,266.

These are folks like many of the millions in this state who can't afford health insurance and can't access it through their jobs because their employers don't provide health benefits or they've been classified as "contractors" on construction sites or "temps" in offices and warehouses.

So they go to county clinics or, in the worst possible option for everyone involved, emergency rooms, where the county spends hundreds of millions of dollars a year treating people when they become so sick they cannot legally be turned away.

Gov. Rick Perry recently tried to lure a business to Texas by touting "the savings in real dollars that would accrue to your bottom line were you to take advantage of the lower labor costs in Texas."

"Low labor costs" means low wages. Low wages mean our people cannot afford to purchase health insurance.

We have created this situation by pursuing policies to keep wages and benefits low by setting the lowest minimum wage possible under federal law.

As conservative columnist Andrew Sullivan recently wrote, "it is precisely capitalism's post-1980s triumph that has helped create the social dependency so many conservatives bemoan today."

We cannot have it both ways. We can either be a low-wage state that needs to help our low-wage citizens purchase health insurance, or we can invest in education and create labor laws that allow people to purchase it for themselves.

Fortunately, many Republican legislators are beginning to agree -- or at least they recognize a darn good deal.

On Thursday, I will be offering an amendment to the state budget that accepts Medicaid under certain conditions, such as efficiency programs and co-pays so patients have a financial stake in their care.

Merely accepting the federal money will save the state so much on what we spend now in emergency rooms and clinics that it will free up $1 billion to invest in our public schools.

The question is, do we hate Obamacare so much that we are willing to turn that away?

Lon Burnam represents Fort Worth's District 90 in the Texas House.

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