More than two thirds of Texans want state leaders to expand Medicaid coverage, a move that Republican officials have been reluctant to pursue over the years, according to results of a poll released Thursday.
The poll conducted by Kaiser Family Foundation and Houston-based Episcopal Health Foundation also found that rising costs is the biggest health care concern among Texans and that 64 percent of Texans feel like the state isn’t doing enough to address the health care needs of low-income adults.
“Policymakers ought to look at this and say people like Medicaid, people think the state needs to take a larger role in access to affordable care, Medicaid is a good program. If you know all of that, why wouldn’t you use all available tools via straight Medicaid expansion or waiver Medicaid expansion?” said Elena Marks, chief executive officer of Episcopal Health Foundation.
The foundations polled a randomized, politically representative sample of 1,367 adult Texans between March 28 and May 8. Kaiser, a policy research organization, has not taken a position on Medicaid expansion, and Episcopal Health Foundation supports Medicaid expansion as one way to improve health care access for Texans.
Texas is one of 14 states that have not expanded the government-subsidized program and are not considering expanding it, according to Kaiser. The option would help cover those who make too much to qualify for Medicaid but too little to qualify for tax credits to buy health insurance from the federally run marketplace.
Former Gov. Rick Perry, Gov. Greg Abbott and other state Republican leaders have strongly opposed expanding Medicaid. State lawmakers have said they don’t trust the federal government to fulfill its promise to reimburse 90 percent of the cost of expansion.
Deane Waldman, director of health care policy at the Texas Public Policy Foundation, an Austin-based conservative think tank, said that states like New Mexico that have expanded are shouldering higher costs than originally expected because of unfunded mandates from the federal government. He also said Medicaid patients don’t necessarily get better care.
“They need to reconnect patients with doctors and get the middle men and all these rules and constraints out of the system,” Waldman said.
Waldman said a better way to lower health care costs and expand access is to decrease the role that government and insurance companies play in people’s health care decisions by enacting a system of health savings accounts, a combination of government and personal money to pay for health care. Account holders would only have to buy catastrophic insurance.
Marks disagrees that quality of care is poorer under Medicaid, citing poll results that found that 71 percent of Texans have a very positive or somewhat positive view of Medicaid. She said if the state wants to avoid certain Medicaid rules and regulations to access money, the federal program can approve that through a waiver program.
“Our survey data says Medicaid is actually not a broken program,” Marks said.