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With or Without You: Counties Ponder Medicaid Expansion Despite Perry’s Opposition

In the aftermath of the Supreme Court’s decision to uphold the Affordable Care Act (ACA), Governor Perry has persisted in his ideological and irrational determination to make enactment of the law as difficult as possible. To the question of accepting direly needed Medicaid expansion funds from the federal government, he has responded with a resounding, “No.” In the state with the highest rate of uninsured individuals, Perry leaves the millions of patients, hospitals, doctors, and taxpayers who could benefit from this money out in the cold.

But Perry’s word is not the last one on Medicaid expansion in the Lone Star State. According to a recent Washington Post article, several larger counties have started discussing the idea of accepting the federal funds on their own:

George Hernandez Jr., CEO of University Health System in San Antonio, came up with the idea of the alternative, county-run Medicaid expansion, and said he has been discussing it with other officials in his county, Bexar. “They are all willing,” he said. He added that he has also been talking up the proposal with officials in other big counties, such as those including Houston and Dallas, and is optimistic they’ll support the idea.

In Bexar county and many others across Texas, programs exist to provide healthcare for the many uninsured Texans who aren’t eligible under the current restrictive requirements. These programs are paid for through local taxes and while they help immensely, they are not reaching as many people as healthcare providers and advocates would like because many people don’t know about them.

Local officials in these counties see the positive impacts of Medicaid expansion - impacts that could benefit the whole state if it weren’t for Perry’s blind stubbornness. These funds would be a boost to the economy, as more or expanded companies would be needed to help manage Medicaid claims and benefits. Also, with a higher rate of those who are currently uninsured able to use Medicaid, hospitals would see a decrease in uncompensated care costs and therefore costs in general, a savings that in turn would be passed on to those with insurance. And because currently so much of healthcare for the uninsured is being taken care of through local taxes, increasing those being enrolled by Medicaid could even lead to lower taxes or expanded services. Above all, it could help many of the 5.6 million Texans without health insurance take better care of themselves and their families.

For some reason, this is not what Governor Perry wants for Texas or for the Texans that Medicaid expansion affects—all of them. But luckily, there are several counties that are able to realize the amazing opportunity these federal funds represent and are willing to do what they can for a chance at it.

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