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Lawmakers Ready To Again Back A 'Texas Solution' To Obamacare

Shelley Kofler
Texas Tribune Editor-In-Chief Evan Smith, Rep. Garnet Coleman, and Rep. John Zerwas discuss another try at passing legislation to access billions in Affordable Care Act funding.

Two key state lawmakers from opposing parties say they haven’t given up on creating a plan that would allow Texas to collect billions of federal Medicaid dollars tied to the Affordable Care Act.

They believe that with Rick Perry leaving the governor’s office there may be another opportunity to adopt a so-called “Texas Solution.”

Rep. Garnet Coleman, a Houston Democrat, and Rep. John Zerwas, a Republican from Richmond, are both health policy experts.  Zerwas is a physician.

So last session -- after Perry said “no” to being part of Obamacare --  Zerwas and Coleman set aside party affiliations and crafted an alternative.

On Monday, at a Richardson forum sponsored by The Texas Tribune and Blue Cross Blue Shield of Texas, they said a majority of state lawmakers were ready to support what they came up with last session -- but Perry’s promise of a veto got in the way.

“Even the conservatives understood their communities would benefit from the boost financially.  From the jobs that would be created,” Coleman said. “[But] there was no reason for members to go out and vote for something they thought would beat them in the Republican primary. And frankly I don’t blame them.”

The Zerwas-Coleman legislation, HB 1391, called for Texas to do what other states have done to collect their share of federal money: Approach the Obama administration with an alternative that provides insurance coverage for more low-income people.

Their plan focused on the estimated 1.5 million Texas adults who earn 138 percent of what the federal government considers poverty level and therefore have no access to affordable coverage. That’s approximately $16,000 or less annually for an individual.

Zerwas says those Texans currently rely on emergency care that often comes too late.

“It doesn’t provide that access when you have early stage breast cancer versus later stage breast cancer,” he said.  “It doesn’t provide you that … access to healthcare when you’ve got diabetes and early in your disease you’re trying to get control of your diabetes so you don’t end up with the serious qualities such as blindness and heart failure.”

The Zerwas-Coleman plan said the newly covered should share some of their insurance cost through co-pays or deductibles, which currently isn’t allowed under Medicaid.  Private insurers would be involved.  Taxes collected from premiums on healthcare plans would pay the state’s costs. 

Zerwas told the Richardson crowd he thinks a similar plan could have a chance next session.

“As we go into this next session if the members hear loud and clear that their constituency wants something to happen, such as a Texas Solution … then I think that, you know, there is the ability to get some traction for things," Zerwas said.

County judges from Dallas, Tarrant, Harris, Bexar, El Paso and Travis recently sent a letter to lawmakers saying medical providers are spending $4 billion a year to cover care low income Texans can’t pay for. 

They’re among those asking legislators to give a Texas solution another try.

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.