Karla Hay, left, colors with her son Anthony Hay, right, as they wait to speak a representative about health insurance enrollment. (Cody Duty/Houston Chronicle)
Strong public support and potential success of the Affordable Care Act could force Texas leaders to eventually reconsider their decision on Medicaid expansion, according to the author of a health care policy brief released this week by the Washington, D.C.-based bipartisan children’s advocacy organization First Focus.
Eugene Lewit, a Standford University consulting health research and policy professor, found similarities when comparing implementation obstacles to the Children’s Health Insurance Program and Affordable Care Act. Focusing on Virginia and Texas, he said both states overcame political resistance to implementation of the Children’s Health Insurance Program, resulting in coverage for more children.
Lewit said he found similarities in resistance to implementation of the 2010 health care law, suggesting states, including Texas, could eventually reverse course and expand Medicaid and cover about 2 million more people statewide.
This week’s brief is one of several Lewit is writing for First Focus.
In comparing Virginia and Texas, the states’ governors delayed implementation of the Children’s Health Insurance Program. However, Texas leaders quickly and aggressively enacted the program after overcoming politics, observing other states’ successes and reconsidering a federal funding forfeiture.
Lewit also found federal policies and practices can minimize implementation resistance. Publicizing “success stories” might encourage competition among states, plus highlight effective program implementation.
“We’ll have to wait and see how it plays out,” Lewit said of the health care law’s success. “If it is successful, it will make it more difficult to resist (Medicaid) expansion. Money is an enormous incentive.”
Lewit’s brief comes as the Obama administration announced 4 million people nationwide have selected coverage in the health insurance marketplace. It’s unclear how many of those people have paid for coverage.
This week, national advocacy groups, including Enroll America and Center for American Progress, have urged uninsured Americans and Texans to sign up for coverage in the health insurance marketplace. A little more than 1 million Harris County residents lack insurance, but half of them probably are too poor to buy insurance and earn too much to qualify for Medicaid, according to the Urban Institute, a private, nonprofit organization that analyzes public policy, including health care.
Earlier this month, U.S. Health and Human Services Secretary Kathleen Sebelius came to Houston to kick off health insurance enrollment events. Since Jan. 1, Texas has lost $10 million per day because state leaders have not expanded Medicaid, she said.
Lucy Nashed, spokeswoman for Gov. Rick Perry, has said Medicaid already accounts for a third of the state’s budget. Taxpayers would spend $18 billion over five years and $115 billion after full implementation of the health care law if the state expanded the program, she said.