Texas is Right to Turn Down Medicaid Expansion

By Rep. Ken Paxton

Texas Insider Report: AUSTIN Texas In my Capitol Steps column a couple of weeks ago I talked about the U.S. Supreme Court decision on the Affordable Care Act also known as Obamacare and why I am opposed to the individual mandate and the expansion of Medicaid.  Ive received feedback from many people in support of repealing the Affordable Care Act and others that have asked for Texas solutions.   Medicaid is a jointly-operated state-federal program that was created in the 1960s to provide a basic safety net for disabled and low-income individuals to have access to health care.  Medicaid has now evolved into an entitlement and the progressive expansion under the Affordable Care Act will make Medicaid unsustainable for the state to continue operating.  Luckily the U.S. Supreme Court gave us the choice of whether to expand or decline to expand Medicaid under federal laws and regulations imposed in the Affordable Care Act. Governor Perry announced recently that Texas will not expand Medicaid nor implement the health benefit exchange in accordance with the Affordable Care Act and I applaud his decision.  In 1987 Medicaid costs accounted for 11 percent of the state budget.  Medicaid now consumes over twice that much growing at a rate that is much faster than the remainder of our budget and our ability to effectively fund state government.  As long as Medicaid grows faster than our economy and consumes more of the state budget we will be hard pressed to maintain our level of funding for transportation homeland security and possibly education which are clearly state responsibilities stipulated in the Texas Constitution.  Over the last decade the Texas Legislature has worked hard to develop state strategies to reduce the cost of health care and empower individuals in making their own health care decisions with respect to Medicaid.  However the regulations and requirements imposed on Texas by Congress prevent us from developing a free-market incentive based system that efficiently aligns the delivery of health care to low-income and disabled individuals which was the original goal of Medicaid. Last session the Legislature passed legislation to ask Congress for a block grant to return our federal Medicaid funds with the flexibility to develop consumer driven health care options that are locally controlled with local accountability.  Block grants can provide flexibility to design Medicaid benefits and eligibility to meet our population.  In addition block grants give the state the authority to empower individuals to seek cost-effective health benefits plans that meet their individual needs with reimbursements based on health care outcomes and performance.  The Affordable Care Act in its current form supersedes the work of the Legislature to make health care more affordable ensure individuals that choose to participate have insurance options that fit their needs and reduce government interference in our health care decisions.  It is more critical now than ever before that Texas has the flexibility to develop a Medicaid system that works efficiently and effectively to give individuals choice and give the Legislature the flexibility to address our other important state responsibilities. Representative Ken Paxton was elected to the Texas House of Representatives in 2002 and is currently in his 4th term representing District 70. Paxton received his BA & MBA from Baylor University and also earned a law degree from the University of Virginia. He and his wife Angela live in McKinney TX and have 4 children.