The Big Conversation
Is the tide turning on Medicaid expansion in Texas?
Despite most state Republican leaders' long-running, steadfast opposition to the expansion, a major component of federal health care reform, momentum is building among lawmakers to reach an agreement that could bring about $100 billion in federal funding to Texas, as the Tribune's Becca Aaronson reports.
The contours of such an agreement could emerge at a House Appropriations Committee this morning.
Though House Republicans on Monday voted to reject the expansion, they said they would reconsider if the Obama administration granted Texas flexibility with the funding. House Speaker Joe Straus, who recently urged fellow Republicans to get their "heads out of the sand" over the Medicaid money, has encouraged lawmakers to develop an alternative proposal by which Texas could expand the program on its own terms.
"After you say 'no,' the next question is, 'Okay, then what?' And we need to move now on something that is more specific that we can put on the table and negotiate," Straus said. "I’m just trying to move the conversation forward on something we can agree is good for Texas and see if there’s some flexibility."
The push for compromise comes as several Republican governors across the country — including Florida's Rick Scott and New Jersey's Chris Christie — have reconsidered their opposition to the expansion. Municipalities, chambers of commerce and health groups in Texas have also ramped up the pressure on state lawmakers to accept the money.
Some Republicans last week expressed interest in a deal the federal government had struck with Arkansas to allow the state to use the Medicaid money to buy private health insurance for individuals. Such a plan for Texas — or a similar block-grant proposal recommended by GOP state Sen. Bob Deuell — would require negotiations with the Obama administration.
"Gov. Perry is a good negotiator, and I don’t think he’ll make a bad deal for Texas," Straus said. "At this point, I want the Legislature to be a good, supportive partner in trying to work out something that does make sense for Texas and Texas taxpayers."
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