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Texas Lawmakers Don't Like ACA, but It Helps Pay Medicaid Tab

Mary K. Caffrey
A provision of the ACA that calls for the federal government to cover a higher share of Texas' administrative costs will help cover $102 million of a $338 million shortfall in Medicaid costs.

US Senator Ted Cruz, R-Texas, made news last week when he announced he will likely enroll his family in Obamacare after years of railing against it.

Apparently, it’s a Texas thing.

Republicans in the Texas Legislature have criticized the Affordable Care Act (ACA) since its inception and refused to expand Medicaid, even though the Lone Star state has the highest number of uninsured Americans. But this week, they discovered that a provision of the ACA will allow the state to collect an extra $102 million toward its unpaid Medicaid bill, which totals $338 million.

The revelation came the same week the leader of a community managed care organization pushed back against what he called unfair perceptions about Medicare’s “burden,” on the state, saying that most recipients are children.

According to the Texas Tribune, Members of the Texas House Appropriations Committee voted Tuesday to partially fund the Medicaid deficit with a $102 million surplus in Medicaid’s “Integrated Eligibility and Enrollment” program. Under the ACA, the federal government started paying a greater share of Texas’ administrative costs to run Medicaid.

When the source of the this surplus was revealed, some Texas Democrats highlighted the irony.

“Many individuals are running away from the ACA, but then we’re taking the benefits, and we’re using the benefits, at least at this point, to pay down on the unfunded Medicaid bill,” said state Representative Sylvester Turner, a Houston Democrat.

State Health and Humans Services officials told the Texas Tribune they had been unsure whether the state would receive the funds, given the refusal to expand Medicaid. Turner, in fact, questioned why state health officials had to leave some other federal funds unspent given Texas’ urgent needs.

Medicaid, and the question of whether it should be expanded in Texas, continues to be controversial in Texas. Advocates for the poor, including many faith-based groups, have begun to contest the portrayal of Medicaid recipients as lazy, malingerers looking for handouts.

Ken Janda, president and CEO of Community Health Choice, a managed care group, wrote in a commentary that Texas leaders are wrong to describe Medicaid as a burden. “Medicaid in Texas equals poor children,” he wrote. The source of its growth, he said, are families stuck in poverty. The state is making innovations in healthcare delivery through a new partnership with the federal government with better preventive care, he wrote, making Medicaid “a blessing, not a burden.”

“Without Medicaid, more sick children would be in our schools and our churches,” Janda writes. “Without Medicaid, more parents would stay home from work, endangering their livelihoods, in an attempt to care for their children.”

Poverty, not Medicaid, is the problem, he states.

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