Counties May Try To Expand Medicaid; State Won’t | KERA News

Counties May Try To Expand Medicaid; State Won’t

Aug 29, 2012

The idea of counties expanding Medicaid with the Affordable Care Act is getting some traction in North Texas. Governor Perry has said the state won’t do it.

He says the Medicaid program in Texas is not efficient or cost-effective and the state budget could not afford the ultimate increase in the portion of Medicaid Texans would pay if the rolls were expanded by as many as a couple-million people.

That’s an estimate of how many more people would be eligible to enroll in the low-income health care program under the Affordable Care Act. The federal government would pick up 100% of the cost for the first three years, then 90% thereafter.

Robert Early, CEO of the JPS Health Network in Fort Worth says the idea of counties, not the state, expanding Medicaid is worthy of serious study.

“If the counties can do things and it’s more efficient, and the Governor and the Legislature see that as valuable, I think it should be part of the debate,” said Early.

Dallas County Judge Clay Jenkins likes the idea. He says the Medicaid expansion under the federal healthcare law would bring millions more in federal dollars to help with the local cost of taking care of low-income patients.

“Dallas County has a hospital district that raises $400 million in local tax dollars to cover the care for individuals at up to 200% of the poverty level,” said the Judge.

At JPS, Robert Early says the money from a county Medicaid expansion could help provide more community clinics for primary care; a “medical home” providing preventive care. He says that would help unclog public hospital emergency rooms. The daily volume at JPS E-R has more than doubled in three years as the North Texas population grows.

“If we continue on that pattern, we’re a wreck looking for a train. And that’s a problem,” said Early. “So I’ve got to figure out wherever monies might be, wherever dollars might be, how I make the system more efficient.”

Early says this should not be a partisan political discussion, but a financial and best practices debate. Dallas County Judge Clay Jenkins says he plans to work hard to come up with a cooperative solution to a complex problem.