Texas Governor Rick Perry Remains Steadfast in Opposition to Medicaid Expansion under Reform

GOP antipathy to Obamacare has followed a smooth, if not entirely predictable trajectory ever since the bill was signed into law in March 2010. The rancor in the lead-up to the law’s passage was met with the usual mix of boisterous townhalls and amiable listening tours. With the media driving the narrative of the law’s role in becoming the first great experiment in healthcare financing and delivery since Medicare and Medicaid some 45 years earlier, the stage was set — for even more drama.

Fast forward to June 2012 and the SCOTUS ruling on upholding the constitutionality of the individual mandate and the unexpected strikedown of the Medicaid expansion requirement for states, and all holy heck breaks loose among the Republicans. The Obama administration breathed a major sign of relief, because the basic tenets of the reform law were held intact: the popular provisions regarding adult dependents’ coverage and required coverage for those with pre-existing chronic conditions; the ultimate formation of healthcare exchanges; and of course, the individual mandate — a favorite proviso among proponents of Obamacare who had to settle for a consolation for the non-starter that was single-payer delivery.

What Obama did not expect, however, was the newfound ability of states to rescind agreements on expansion for Medicaid coverage. Combine this sentiment with Tea Party values and influence (and for that matter, this) and one has a seemingly neverending boilerplate talking point on the public “referendum” of Obamacare: completely shut out healthcare delivery to sickest, poorest, heaviest utilizers of care so that the cost of care rises even higher — affecting not only patient access to care, but the fiscal bottom lines for acute hospitals to deliver that care.

Texas Governor Rick Perry is a Medicaid expansion holdout. Helming one of the most uninsured states in the country, the GOP chief executive will be responsible for the loss of approximately $100B from the feds and $7B from payments to hospitals to provide care to these patients who would have had coverage. The consequence is essentially funding uncompensated care in Texas, mostly coming out of the pockets of taxpayers. Many believe Perry is considering another run for the presidency and can’t afford to be “primaried” by emerging Tea Party candidates in the mold of Senator Ted Cruz, for example, who consider any “allegiance” to Obamacare a lethal one. It will be very interesting to see how Texas navigates its own brand of healthcare financing over the next two to three years. | LINK

24. May 2013 by Michael Douglas, MD, MBA
Categories: CMS, Corporate, Healthcare Policy & The Media, Politics & The Law | Tags: , , , , , , , , , , , , , | Comments Off