Health care advocates flocked to the Capitol on Thursday to urge the Senate Finance Committee to consider the benefits of expanding Medicaid to impoverished adults, restoring funding for family planning services cut last session and encouraging a redesign of the state’s health delivery system to help additional disabled and low-income Texans.
“Our Medicaid system is far from perfect, but for people that don’t have access to health care, it can be a life saver,” said Kim Campbell, a Texan with multiple sclerosis, who testified in favor of lawmakers expanding Medicaid to cover impoverished adults.
On Wednesday, the committee heard testimony from state officials on the proposed health budget, which grew 2 percent from the current biennium budget to $70 billion. The chairman of the committee, Sen. Tommy Williams, R-The Woodlands, expressed the need for fiscal conservancy but said the decisions lawmakers make this session will not be “whether we’re going to serve that population or not — it’s going to be about how they are served.”
Bee Moorhead, the executive director of Texas Impact, an interfaith group that commissioned a recent report on the benefits of expanding Medicaid, said taxpayers deserve to have money they paid returned to their communities through the Medicaid expansion. “I think taxpayers deserve a serious answer from lawmakers on why the state doesn’t want to give them this kind of relief when its so easily available to them,” she said.
Sen. Juan "Chuy" Hinojosa, D-McAllen, agreed with testimony that even if Texas does not expand Medicaid, there will be continued costs for caring for the uninsured. “The costs would be born usually by local governments,” he said.
But Republican lawmakers challenged the testimony provided by advocates of the Medicaid expansion.
“You’re going to create a new class of uninsured people at higher income levels,” said Sen. Bob Deuell, R-Greenville, adding that employers will choose to drop employee health coverage if the state expands Medicaid, causing the pool of private insurance to shrink and premiums to rise. “I want everybody to have health care, but I think there are better ways to do it.”
Others testified on restoring family planning services. State lawmakers cut funding for family planning services in the last legislative session by two-thirds, dropping the two-year family planning budget from $111 million to $37.9 million for the 2012-13 biennium. They also approved a tiered budget system for family planning funds, which gives funding priority to public health clinics, such as federally qualified health centers and comprehensive clinics that provide primary and preventative care over clinics that only provide family planning services.
A representative from Parkland Hospital in Dallas testified that the family planning cuts caused their facilities to lose $4.7 million for women’s health services. She said those costs shifted to Dallas county taxpayers, as the four clinics that lost funding completely began utilizing a $25 co-pay and local county tax dollars to continuing providing needed services, such as cancer screenings, contraception and testing for sexually transmitted infections.
“We’re all about prevention — we’re not about any particular provider, we’re not about an argument of abortion rights or abortion,” said Janet Realini, a family physician in San Antonio who chairs the Texas Women’s Health Care Coalition, a group of 31 health and faith organizations working to restore funding for family planning and women’s health services. She said cuts to family planning caused 130,000 women to lose access to preventive health services in Texas.
“We really have a precarious situation in terms of access,” because even if funding were restored to previous levels, it would only serve a third of the population in need of services, she said.
A married mother of two offered her story. Uninsured for three years, she had difficulty finding an affordable place to have tests performed because she opposes abortion, and the only affordable provider was Planned Parenthood.
“Planned Parenthood ran a monopoly in this state; you could not find other alternatives,” she told lawmakers, explaining that she could not find affordable services from the providers listed on the state website “because the [federally qualified health centers] don’t exist like everyone would like to think that they do.”
Advocates continually referenced a statement made by Sen. Jane Nelson, R-Flower Mound, at Wednesday’s hearing that Texas needs “to look at spending [state dollars] differently and getting more bang for our buck.”
Meagan Longley, a mental health fellow at the Hogg Foundation, cited Nelson’s quote before advocating for reaching patients with mental health problems in primary care settings through integrative health care programs. She said such a redesign would allow for earlier detection and intervention in mental illnesses, “which always leads to improved outcomes and decreased costs.”
Others offered support for disability services. Lawmakers have proposed funding many programs at consistent or reduced levels, but agencies have requested additional funding.
The Department of Disability and Rehabilitative Services "is the conduit for people with disabilities who want to transition back into mainstream society," a disabled veteran said of how the state agency helped him graduate from a program at the University of Houston. “Their disabilities say one thing, but their heart, their mind, their guts to live with disabilities says something else.”