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The Texas GOP left them out

The human cost of the Texas GOP’s unwillingness to expand Medicaid, keeping people uninsured for ideological reasons, is cruel. Via TPM, Americans In Medicaid Gap Enlisted To Fight Back Against GOP Guvs.

Obamacare advocates are actively recruiting those left out of the Medicaid expansion in Republican-controlled states to lobby state officials to change their minds and participate in that key provision of the health care reform law.

So far, the effort is most organized in Texas, which is also the state with the most people in that Medicaid expansion gap: 1 million. But it’s likely to pick up elsewhere as the Obama administration and outside advocates apply pressure to the 25 states that have resisted expansion for the first year.

Texas Left Me Out, the combined effort of several community groups, is a website designed to collect those people’s stories and organize them into a cohesive political action constituency. It asks those in the Medicaid gap to sign a petition to stay informed about advocacy events and share their story on the site.

Are they going to turn Texas blue on the backs of people who have traditionally been ignored by Republicans? Are they going to convince an anti-Obamacare stalwart like Rick Perry to buy into the law? That’s a tough sell. But they’re going to try.

“When you personalize a policy, when you make it real, it’s always much more powerful. It’s always going to resonate,” Tiffany Hogue, state health care campaign coordinator at the Texas Organizing Project, one of the groups involved with the campaign, told TPM. “People have really have awakened to the fact that people really are getting left behind.”


The strategy is simple: sheer political force. They’ll ask people to turn up at legislative committee hearings and stage protests at the state capitol. Conference calls and press conferences will be the norm. They aren’t waiting for 2015 either. A group is going to a state insurance department meeting Dec. 20 to rally for expansion.

Those left out of the expansion are receptive to the effort. Irma Aguilar, a separated mother of four who lives in San Antonio and has been recruited by the Texas groups, said it was a “a real shocker” when an Obamacare canvasser came to her house to explain her options to her under the law, only to find out that her income as an assistant manager at Pizza Hut was too low to qualify for financial assistance to purchase private insurance and she couldn’t sign up for Medicaid because Perry and the GOP-led legislature had rejected the expansion.

“They didn’t want to take that extra money to help us poor people back here,” she told TPM. “What about us back here? It’s really hard. I thought with this law, they would try to work to help everybody, but apparently not. They just think of themselves. They’ve just let us struggle.” [Emphasis added]

A 28-year-old with high blood pressure and back problems, Arguilar’s story is exactly the kind that advocates hope to use to persuade Republican state leaders. It might not work on its own — it didn’t in 2013 — but that human interest angle paired with the business case that high-powered lobbying groups like the Texas Hospital Association will make is seen as a potentially winning formula by those pushing for expansion. They’ll be arguing that drawing down on billions in federal funds will be a boon for the state’s economy.

It’s likely to spread beyond Texas, too. The White House has already called out 11 non-expanding states in conference calls and events with local officials, using the two-pronged argument of extending health coverage to the uninsured as well as bringing in those billions of Medicaid dollars to advocate for expansion.

They just think of themselves, they just let us struggle. That’s the cruelty inherent in the GOP’s decision not to expand Medicaid. As BOR points out Gregg Abbott has no plan whatsoever to help the poor get health coverage, Even Greg Abbott’s Advisors Lack Answers For Texas’ Uninsured.  As this recent article in the Texas Observer shows, The Money Behind the Fight to Undermine Medicaid, the people who make GOP policy in Texas won’t allow it.

On April 1, Texas’ most powerful elected officials gathered at the state Capitol to rail against Medicaid. In a packed press conference room with protesters shouting outside the door, Republican Gov. Rick Perry, Lt. Gov. David Dewhurst, and U.S. Sens. John Cornyn and Ted Cruz made clear to reporters that Texas—the state with the nation’s largest uninsured population—wouldn’t expand the program that provides health insurance to the poor and disabled.

pphflagUnder the Affordable Care Act, the federal government would have largely paid for Medicaid to cover an additional 1.5 million Texans. But the state’s Republican leaders instead called for the federal government to “block grant” Medicaid, giving them a lump sum of money to run the program as they see fit. Dewhurst compared expanding the current Medicaid system to drug addiction. “Would you consider expanding a broken system? Of course not, of course not,” Dewhurst said. “It’s like a drug dealer. You give them their first hit free and then they’re hooked for years and years.”

The group that organized the press conference and supplied the policy prescription was the Texas Public Policy Foundation (TPPF), an influential think tank funded largely by right-wing foundations, corporations and wealthy Texans. TPPF has been instrumental in preventing increased spending on Medicaid and other social welfare programs in Texas. Perry, Cruz, Cornyn and other politicians frequently turn to TPPF to help make the intellectual case for reducing government involvement in health care. The press conference was part of TPPF’s multi-year strategy to remake Medicaid in accordance with free-market principles. The think tank would later claim credit for helping block Medicaid expansion in Texas under Obamacare.

The financial cost to Texas is high as well, this policy is costing Texas billions. It was clear during the last legislative session that if Republicans in The Lege had wanted to try and get to a Texas “solution” to expand Medicaid, the Obama administration was willing to work with Texas.  They were not going to “block grant” the money, but they could have worked out something like Arkansas did. 

What that means is that the leaders of the Texas GOP made a conscious and calculated decision not to expand Medicaid and keep over a million Texans without health insurance coverage for ideological reasons. 

Which leads us back to the same place we always get to eventually in Texas.  We have to elect people who will do things for the people and not wealthy right wing donors and corporations only.  Democrats and specifically Wendy Davis, are committed to expanding Medicaid.  Having a Governor that will not veto legislation to expand Medicaid is key to getting it enacted in Texas.  If Abbott is elected we will just get more of the same and these people will stay left out, without health care, unnecessarily for years to come.  If Wendy Davis is elected they will be almost guaranteed of getting the health insurance the Texas GOP is denying them.


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