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Will Texas Reverse Decision, Provide Medicaid To 1.5 Million?

Governor Rick Perry is adamant, Texas will not make Medicaid available to more Texans by taking part in a federal program. But recently other Republican governors in Nevada and Arizona have changed their minds, saying they can’t ignore the billions of federal dollars they’d lose by opting out.

Lawmakers in Austin are now debating what Texas should do, including a senator from  Greenville who also wears a stethoscope.  

At a time when many Texas doctors won’t accept Medicaid patients because the reimbursement rate is so low, Dr. Bob Deuell treats them. One fourth of his patients, mostly children and pregnant women, are covered by Medicaid.

Medicaid isn’t currently available to most other adults in Texas. But that would change if the state reverses course and joins the federal program that allows more lower income people to sign up. Adults and children in a family of three with income of about $25,000 a year would qualify.

Deuell doesn’t think Texas should expand Medicaid.

“The federal government is $16 trillion in debt. So they can’t afford it. We can’t afford it,” he said.

Dr. Deuell is also Republican State Senator Deuell. He recites a long list of reasons he thinks Governor Perry made the right decision. First of all, he thinks greater access to Medicaid would create chaos for those with private insurance.

“You have smaller pools for the rest of the folks who aren’t eligible for Medicaid and that will increase the insurance premiums and costs for everybody in the state,” Deuell said.

Then there’s the federal funding, the deal Perry rejected. In exchange for Texas spending just over $3 billion during the first three years, the federal government would give the state nearly $27 billion- nine times as much. The new money would buy health coverage for 1.5 million uninsured Texans.

Deuell, however, questions whether Washington would keep its promise to pay 100 percent of the cost to insure new patients for the first three years and at least 90-percent after that.

And he has a philosophical objection. He thinks making the Medicaid program bigger is wrong.

“Is it the state’s fault that we have 23 some percent uninsured? I would submit, no. If it is not the state’s fault then is it the state’s responsibility to provide care to those people and I would say also, no. Many uninsured can afford insurance and they just choose not to have it,” Deuell said.

Senator Rodney Ellis, a Houston Democrat disagrees.

“I think government has an obligation to do its best to give as many people access to healthcare as humanly possible,” said Ellis.

Sen. Ellis has filed a bill, SJR 8,  that calls for voters to decide whether Medicaid eligibility is expanded in Texas.

“It is just hard for me to understand any scenario on God’s green earth for denying healthcare to 1.5 million people in Texas because you think you can somehow defy the law that’s in place," said Ellis.

“Instead of having members of the Texas House and the Senate and the governor wrangle and argue about what we should or shouldn’t do let the voters of Texas decide it,” he said.

The voters in Senator Deuell’s community of Greenville don’t agree on the issue either.

At Landon’s winery three friends nodded agreement as Price Bradshaw explained why Texas should let the federal government keep the money.

“Think how hard it is to get in to see doctors today. And think what it’s going to be like in times to come. Another part of it is I believe the source of funding for this is the taxpayers. All of us are going to be paying for it today, tomorrow and hereafter,” said Price.

Across the street at a used car lot that’s been turned into a flea market, vendors said greater access to Medicaid would be a lifeline to many working Texans.

“We should do it. Absolutely,” said Rick Francis who said his wife had breast cancer and he’s worried about his uninsured, working daughter who is at higher risk.

Ann New says her self-employed sister needs medical care but can’t afford it.

“She can’t get coverage because she can’t afford $400 to $500 a month. So she’s falling through the cracks. It upsets me that she’s worked all her life and because she owns a business that doesn’t have more than four employees she doesn’t have insurance.”

Sen. Deuell says Texas can care for more of the uninsured without more Medicaid. He wants to increase Medicaid payments to doctors so they can afford to provide more charity care. He thinks more churches could also step up.

“The church has really neglected its role in providing health services to the uninsured and low income people. To me it should not be a government as much as a church function,” said Deuell.

But Senator Ellis says Texas needs to bank on the big federal bucks. He doesn’t believe charitable doctors or churches can provide the $27 billion in care Texas would get from Washington.

Former KERA staffer Shelley Kofler was news director, managing editor and senior reporter. She is an award-winning reporter and television producer who previously served as the Austin bureau chief and legislative reporter for North Texas ABC affiliate WFAA-TV.