You are here

4 Things Texans Should Know as Congress Takes Aim at Health Care

As the national health care debate kicks into high gear, here are four things that Texans need to know:

1. Repealing health coverage without immediately passing a replacement plan would eliminate insurance for 2.6 million Texans.

Congressional leaders and the President-elect have long talked about the need to “repeal and replace” the ACA.

Now they say they plan to pass legislation in January to repeal health coverage starting at a future date -- and then hope they can figure out the “replace” plan before that date arrives.

A recent report from the Urban Institute found that 2.6 million Texans would lose their health coverage under this scenario.

We believe that any legislation to repeal health protections for children and families needs to include the immediate replacement of those health protections.

2. Turning Medicaid into a block grant means more painful cuts like the highly unpopular Texas therapy rate cuts for kids with disabilities.

Congress isn’t just taking aim at the ACA. They’re also targeting Medicaid, considering turning it into a block grant (or a similar "per capita cap") and vastly shrinking the program.

Turning Medicaid into a block grant means cutting health care and shifting the costs to states.

In fact, Representative Tom Price -- who has been tapped to run the Health and Human Services Department under the next administration -- has proposed a block grant strategy that cuts Medicaid by one-third over 10 years.

It’s an approach that Texas leaders, including members of the Texas Senate Health and Human Services Committee, have called for in the past. If Congress gives them a green light, state leaders may suddenly face the task of turning that rhetoric into real policy decisions.

It won’t be pretty. In Texas, 96 percent of people on Medicaid are low-income children, seniors, pregnant women, or people with disabilities. So the question is: Which of these low-income Texans do our elected officials want to cut?

There are so few places to cut our state’s barebones Medicaid program that the state’s most recent effort resulted in rate cuts for therapies for children with disabilities. Not surprisingly, there’s been a huge backlash to those cuts, but we’ll see more cuts like those if Congress and state leaders pursue Medicaid block grants.

3. Open enrollment for ACA Marketplace insurance is going strong!

While there is a lot of uncertainty about the future of health care, ACA insurance will still be available at least through 2017.

Enrollment has been brisk across the country and here in Texas, with 220,300 Texans signing up in November. The vast majority of Texans signing up for health coverage through the Marketplace receive premium assistance.

Open enrollment will continue through January, but December 15 is the deadline to enroll in coverage that begins on January 1, 2017

4. While attention is on Congress, key health care decisions will also be made soon in Texas.

When the Texas legislative session starts in January, we expect lawmakers to consider a number of helpful proposals, such as legislation to address postpartum depression, shore up the state’s new women’s health programs, streamline children’s enrollment in Medicaid, restore funding for therapy for kids with disabilities, and more.   

While previous Medicaid expansion proposals may be on hold, we will continue to advocate for a Texas plan to expand health coverage to reach the 4.6 million uninsured Texans.

As Texas tries to negotiate a renewal of the 1115 Medicaid Waiver funding that expires at the end of 2017, we are hopeful that state officials will succeed -- and that an updated Waiver will include a plan to cover the more than one million Texans that could be insured through Medicaid expansion funding.

And of course we’ll be keeping an eye out for proposals to make it harder for Texans to see a doctor and stay healthy.

It’s going to be a busy few weeks and months, so stay tuned!