Burnam withdraws Medicaid measure after setback

Posted Friday, Apr. 05, 2013  comments  Print Reprints
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AUSTIN -- The bitter debate over Medicaid expansion erupted on the House floor Thursday as lawmakers working on the state budget backed away from an amendment they passed that was perceived as a bid to bring more federal Medicaid dollars to Texas.

House members initially approved the amendment by Rep. Lon Burnam, D-Fort Worth, with little debate. But after a blitz of conservative email alerts warning that it could lead to Medicaid expansion in Texas, they moved to reconsider the vote.

Burnam, acknowledging likely defeat, then withdrew the amendment.

In dueling news conferences Monday, Gov. Rick Perry and other leading Republicans renewed their opposition to expanding Medicaid coverage while high-profile Democrats led by San Antonio Mayor Julian Castro and his congressman brother, Joaquin, embraced it.

Proponents of expansion have said that the state could get $79 billion in federal funds over the next 10 years with a state investment of $8.8 billion. Perry and other Republicans say that agreeing to an expansion under the federal Affordable Care Act would continue the state's participation in an unsustainable federal program.

Burnam said his amendment did not expand Medicaid but instead enabled the Texas Health and Human Services Commission to set conditions if the state engaged in negotiations with the Obama administration on the subject. The proposal essentially mirrored Senate parameters directing the commission to establish criteria for a "Texas Plan" if the state engages in discussions for additional Medicaid dollars.

"Does this amendment mandate a Medicaid expansion? No." Burnam told House members as he urged lawmakers to keep his amendment in the $193.8 billion budget.

Instead, he said, the proposal "simply allows us to continue talking about what most Republican-controlled states are doing across the country to try to bring more dollars to their state.

“It makes a whole lot of sense to keep your options open as long as you can keep them open,” Burnam said. “I thought it made a whole lot of sense.”

Burnam said billions of additional federal dollars could provide a big boost for the healthcare industry in Texas, including hospitals in his Fort Worth district.

“We’re talking about a huge economic engine as big as the Defense Department dollars that my district is so grateful for,” he said.

Several major health associations, Burnam said, “kicked into gear” to defend the amendment after Rep. Geanie Morrison, R-Victoria, made a motion that the House reconsider it.

“I just want to rewind and start over,” Morrison said. “This is a very important issue. . . . There were a lot of people, including myself, who were not clear on what was happening.”

Rep. Lois Kolkhorst, R-Brenham, said she worried that the amendment could be an opening step toward Medicaid expansion, which she said she opposed.

“I am really convinced that we can do better by not taking these dollars right now,” said Kolkhorst. “Our option right now is not to do this.”

Others sought to tamp down over-reaction to Burnam’s amendment.

“We should all take a deep breath and remember where we are,” said Rep. Craig Eiland, D-Galveston. “The governor has said quite clearly that there will be no Medicaid expansion as it is currently proposed. There is one thing that I know. If he ever tells you he will veto something, it is not a threat. It is a promise.”

House members approved the amendment at midafternoon by a vote of 86-57.

The 93-54 vote to reconsider the amendment came several hours later after a full day of debate on the budget.

The reconsideration vote would have been followed by further debate on the merits of the amendment but Burnam quickly announced his decision to withdraw the proposal.

“It keeps the door open for the conversation,” Burnam said of his amendment. “Now the governor has not seemed very flexible at all, but the more people focus on how much money is involved in here, the more pragmatic people are becoming.

“There are more and more Republicans in the House and the Senate that recognize that we need to start negotiating with the people responsible for implementing Obama Care. It’s potentially huge.”

Burnam, who has a reputation as one of the more liberal Democrats in the Republican-controlled House, said he worked with the GOP leadership to help smooth the way for the amendment.

Rep. John Zerwas, R-Richmond, a physician and a Republican point man on health care issues, consulted with Burnam and added language that Burnam agreed to accept.

Dave Montgomery is the Star-Telegram's Austin bureau chief. 512-739-4471

Twitter: @daveymontgomery

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