Texas, one of the states previously most resistant to the Medicaid expansion, may be reconsidering that hostility. According to the LA Times, Texas Gov.elect Gregg Abbott may be more open than his predecessor, Gov. Rick Perry, to the expansion:
At a meeting with Houston-area state legislators, the Houston Chronicle reported, Abbott asked for more information about Utah’s groundbreaking compromise with the feds on Medicaid expansion.Abbott himself initiated the discussion of Medicaid, “a topic so radioactive in Texas politics that even the mention of it caught the room off guard,” according to the Chronicle. The state legislature’s valiant pro-Medicaid minority isn’t ready to declare victory, but one remarked, “it sounded like at least he’s looking at options.”
The political logic behind expanding Medicaid in red states is apparently good enough—or, at least, not bad enough—that many Republican Governors have already embraced it. The approach taken by Utah, which incorporates federal subsidies for private insurance, would be key to giving Texas ideological cover. But if Texas does expand Medicaid, the new enrollees in the system will face many of the same problems plaguing the problem nationally: namely, difficulties in actually seeing doctors. It is ironic that Texas is reconsidering its opposition just as papers like the New York Times have begun to realize how bad the access restrictions are, or will soon be. The truth is that our system is not equipped to handle an expansion like this very well.The next debate about health care should be about reforms that lower costs and expand the pool of care providers. Until that happens, gestures like the Medicaid expansion may sound nice in theory, but are not that useful to many enrollees in practice.