COMMENTARY: Medicaid expansion: Good for business, good for families

I have long been a supporter of expanding Medicaid because I agree with Joe Straus, our former Republican speaker of the House, that government should be run like a successful business (San Antonio Express-News, Oct. 21). Expanding Medicaid is a wise fiscal policy, and it’s long past time for Texas to embrace it.

Many states have recently adopted Medicaid expansion; but Texas has been reluctant to follow that lead. I’m proud that Texas follows the beat of its own drummer; but in this case, Texans are missing out.

In previous sessions, opponents have argued that Medicaid expansion costs too much. I believe not expanding Medicaid costs much more.

Not only is Medicaid expansion common sense, but it literally makes financial “cents.”

The federal government doesn’t magically have money of its own; it raises revenue from the taxes that you and I pay, and I believe that we should get back as much of that money as we possibly can.

We can go a long way toward accomplishing this by expanding Medicaid because the federal government gives us back money to spend on Medicaid, and the amount of money the federal government gives back is determined by how much we’re willing to spend directly from Texas coffers. The more skin in the game from Texas, the greater the return from the federal government. We’ve all heard the words, but what does Medicaid expansion really mean? It means investing just enough state dollars to pull down the most federal funds to Texas by expanding Medicaid healthcare coverage to certain eligible adults.

Imagine if the bank told you for every 10 cents you invested into your savings account, it would invest 90 cents in your savings account. So, you could place $1 into your savings and get nine more dollars from the bank; or put $10 into savings and get 90 more dollars from the bank. You’d put more money in savings — but you’d get even more from the bank. Now that’s a deal ù and it’s exactly the deal the federal government is offering to Texas if we’d only expand Medicaid. If Texas expanded Medicaid, federal funds would pay for 90% of the state’s program funding, reducing Texas’ liability for Medicaid expenses to just 10%.

Because Texas has failed to expand Medicaid, the federal government covers only 62% of our state’s Medicaid expenses — which means Texans pay 38% directly for Medicaid healthcare costs. However, by expanding Medicaid, data experts project the state would make a net gain of $54 million a year, or almost $110 million additional revenue for the biennium.

These are our tax dollars that we’ve already paid to the federal government; we’re just not drawing them down because we won’t expand Medicaid.

Instead of wasting state dollars on healthcare services that the federal government would pay for if we expanded Medicaid, Texas could spend more money on public education, small business growth and economic opportunities for Texans.

This upcoming session, the Texas Legislature is facing a $4.6 billion budget shortfall, and we’ll have to make

painful and difficult decisions. Now more than ever, I believe that my colleagues in the Legislature should embrace Medicaid expansion because it’s good for business, good for revenue, and good for Texas families.

Additionally, secondary benefits are expected to arise as a result of Medicaid expansion, such as increased employment rates, fewer uncompensated care expenses and less spending per individual enrollee.

It is also well documented that other states that have expanded Medicaid have seen patient outcomes improve and the gaps in health disparities close.

Furthermore, rural Texans would greatly benefit from Medicaid expansion. Folks living in rural Texas make up 11% of our state’s Medicaid expansion-eligible population and have the most to gain. Rural hospital closures have caused healthcare catastrophes across Texas, which in turn have caused deteriorating health outcomes and crumbling local economies for rural Texans. This is of special importance to us all because parts of the Rio Grande Valley and surrounding areas are still considered rural communities, so we all know how difficult it is to get medical attention. Oftentimes, even a few seconds can make the difference between life or death.

Texas is one of only 12 remaining states that have not agreed to expand Medicaid. It is about time we stop seeing “Medicaid expansion” as a political term and start seeing it from the commonsense and business standpoint that results in almost 1 million newly eligible adults and $110 million in funding for the upcoming biennium. Businesses know a healthy work force is a productive work force.

If we are serious about making up for the budget shortfall and creating a stronger and healthier Texas, then leaders must commit to expand Medicaid. You’ve certainly got a commitment from me.

State Rep. R.D. “Bobby” Guerra, D-McAllen, represents District 41 in the Texas House of Representatives. He represents the cities of McAllen, Mission, Edinburg, Palmhurst, Alton, and Pharr.