Wednesday, April 8, 2015

A Formal Rejection of the Rejection to Expand Medicaid in Texas

With the passage of the Affordable Care Act in 2010, and the subsequent Supreme Court case in 2012, institution of the law was ready to go into effect by 2013. Ideally, States would set up their own insurance marketplaces, and the Federal Government would subsidize rates so that millions of uninsured Americans could have access to affordable health care. Obviously, there's much more to it than this, but essentially this is the purpose of the law. If the situation is less than ideal, it always is, and some States wished to opt out of expanding Medicaid for whatever reason, the Federal Government would set up a marketplace for them but would not fund that State's Medicaid expansion, and could not compel the State to do so on it's own.
 
Unsurprisingly, Texas, or rather it's elected leaders, opted out of the Federally funded, named-after-our-enemy, evil plan to bring healthcare to all. Essentially, the reasons for opting out boil down to two very stubborn points:
 1) Due to the Supreme Court ruling and complications in the law that arose from it, Obamacare is a very perilous financial endeavour. With a National debt of 16 trillion dollars, financial recklessness raises Republican eyebrows.

2) Obama's election, the passage of the ACA, and the general liberal tide of the country, evoked in this most red of States a "last stand" feeling about Obamacare and we would do nothing to make it seem as though we accept it. Not even accept an offer to insure our people. Accepting it would give too much control to the Federal Government over Texans' choices for healthcare.

To the first point, it is quite true that in 2013 the ACA was financially tremulous. Over the past two years, however, it has gained confidence and merit. It's initial offer remains intact. The Federal Government would fund an expansion of Medicaid such that 1.5 million currently uninsured Texans could have access to affordable healthcare. It would fund 100% the program for the first 3 years, and would decrease that amount over time, though it would never fall below 90%. It would also bring much needed appropriations to public Hospitals throughout the State. As it is, some County Hospitals are closing because they can not  continue without the funds the Federal Government would provide.

  The fact the the second issue is ideological in nature, in many ways makes it extremely hard to argue with, though it doesn't hold much rhetorical value. In many ways there are some very commendable things to be said about the Republican tenacity on this issue. Yet, if we put ideals and dogmatic political philosophy aside,  the key question then, is this: Are the political ideals of the State, however good and right they may be, to be considered more heavily than the well being of the people in that State?

5 years after the ACA became law, and 3 after it's been implemented, I hope Texan leaders can put aside what may be valid political convictions, and seek what will best care for the People of Texas in the long run. Reevaluate Texas' rejection of the Affordable Care Act.

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