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Rodríguez: Expanding Medicaid makes sense for Texas

State Senator José Rodríguez

  Commentary: The latest U.S. Census Bureau figures show Texas still holds the dubious distinction of having the highest number and percentage of uninsured, but there was some good news.

Because of Obamacare, there are 1.1 million fewer uninsured Texans, and our uninsured rate dropped from nearly 25 percent in 2013 to 17 percent.

Of the 4.6 million remaining uninsured Texans, nearly 1 million could be helped by another part of Obamacare. These are Texans who make too little to qualify for the discounted health plans provided through the marketplace. Many work in the food and service industries; others can only work part-time because of disability or diseases like multiple sclerosis and cancer.

Unfortunately, the majority of the Texas Legislature refuses to deal with this issue.

This is shortsighted. Health care and the economy go hand-in-hand – a healthy workforce is a more productive workforce.

Two noteworthy statistics:

• According to the Centers for Disease Control and Prevention, productivity losses related to personal and family health problems cost U.S. employers $1,685 per employee, or $225.8 billion annually.

• The No. 1 cause of homelessness and personal bankruptcies is health care costs. Both have a profound impact on the economic vitality of families and communities.

In the first case, the cost is in the form of lost earnings by businesses. In the latter, the cost is borne directly – first by individuals, and then by everyone around them, as communities take on the task of supporting people in hard times.

These costs can be avoided if we invested up-front in making sure that people have the opportunity to be healthy.

While the individual has a responsibility to take care of her/his health proactively through diet and exercise, unexpected events occur. Nobody can predict a car accident; disease can strike quickly. In those cases, access to affordable, quality health care is critical.

While there are many moral ways to describe this – as a social good, a helping hand, compassion – it's also common sense from an economic standpoint.

Businesses understand this, which is why they offer health coverage; it's an investment in their employees. It’s also why the Texas Association of Business, the Greater El Paso Chamber of Commerce, and numerous business groups favor expanding access to health care.

We can provide coverage for a million Texans while getting back tens of billions of our federal tax dollars by embracing Obamacare, and working on a uniquely Texas way of administering the program.

The details can be sorted out if we all agree on the core value of ensuring people have access to health care.

The situation is even more acute now, as the 1115 Transformation Waiver, a mechanism that has preserved payments to hospitals for uninsured care and provided incentive payments for improved health outcomes, is set to expire.

That means billions of dollars that the federal government sent to hospitals and local communities to alleviate the burden of uncompensated care will no longer come to Texas.

If the waiver expires without a plan in place, Texas would lose $1.3 billion in federal funding in 2018 alone, according to estimates by the Center for Public Policy Priorities. In El Paso, that means a loss of $86 million.

The federal agency in charge has made it clear that they will not continue these high uncompensated care payments that cover care in the most expensive setting (i.e., hospitals) when we can provide access to care for uninsured Texans in a much cheaper way.

State leaders can continue to choose politics over policy, and refuse to come to the table with solutions for our uninsured, but that doesn’t mean “federal taxpayers… have to underwrite that bad decision.”

We can make a dent in this massive problem with bold action by the state. It's the right thing to do, and it's good business.

José Rodríguez represents District 29 in the Texas Senate, which includes El Paso County.