The Texas House gave final approval Tuesday to a Medicaid reform bill that includes an amendment rejecting Medicaid expansion under the federal Affordable Care Act.
Rep. Jeff Leach, R-Plano, said his amendment takes away authority for the head of the state’s Health and Human Services Commission to negotiate Medicaid expansion with the federal government — potentially providing coverage for up to 1.5 million low-income, uninsured Texans — without approval from the Legislature.
“Many of us are very wary of Medicaid expansion,” Leach said Monday, when his amendment was adopted 87-57 in a late night vote. “We understand there’s a problem with uninsureds in Texas, but we don’t believe Obamacare is the answer to that.”
Rep. John Zerwas, R-Simonton, opposed the Leach amendment to Senate Bill 7, saying it could hamstring state efforts to negotiate a wide array of health care options, many with federal matching dollars.
“We only meet every other year for five months. I’m concerned that the broad stroke that this amendment makes is going to really handicap our ability” to negotiate, Zerwas said.
Rep. Mark Strama, D-Austin, argued that the Leach amendment would sell Texas taxpayers short.
“We will still pay the taxes required of us under the Care Act. The difference will be, we will pay it to provide health insurance to other states’ low-income citizens instead of our own. How that constitutes fiscal conservatism is beyond my comprehension,” Strama said.
But Leach said his amendment would not constrain future governors and health officials from choosing to expand Medicaid. They would, however, need legislative approval first, he said.
“If we want to have the debate about Obamacare, about expanding Medicaid, let’s have that debate in this chamber, in this Legislature,” Leach said.
The House voted 139-5 Tuesday to give final approval to SB 7, which redesigns long-term services for senior citizens and those with intellectual disabilities by expanding managed care throughout Medicaid, including nursing homes. The measure also rewards “quality-based care” that successfully treats patients, as opposed to paying more money to those who provide more treatment.
Before the bill can be sent to the governor, differing House and Senate versions will have to be resolved, including changes the House made to deadlines in the move to managed care.