On Friday evening, Dan Patrick’s office sent an announcement: on March 2nd the lieutenant governor, along with Senator Charles Schwertner and “other senators”, would hold a press conference on the subject of Medicaid flexibility. The topic was an intriguing one. Texas, of course, is one of the states that has declined to expand Medicaid under the provisions of the Affordable Care Act. Efforts to consider the subject, in 2013, were unceremoniously squashed, and nothing has happened in the interim that would make Texas more receptive to the federal government’s preferences. Schwertner, who chairs the Senate Health and Human Services committee, dismissed the idea bluntly months ago: “expanding Medicaid in its current form is a nonstarter for Texas.” Plus the date, March 2nd, was a dead giveaway.
The press conference confirmed the Senate’s position: Texas will not expand Medicaid in its current form. The idea of doing so, Schwertner added, “is simply not worth discussing.” And if the president doesn’t like that, apparently, it’s incumbent on him to be flexible. Patrick and Schwertner produced a letter to Barack Obama, signed by all 20 Senate Republicans, laying out their list of demands. They want the federal government to give Texas the latitude to implement ten reforms (“at minimum”) in the current Medicaid program, then, and only then, Texas would come back to the table—maybe.
It was an aggressive approach, considering that the Texas Senate can’t force the federal government to accept its conditions; but a defensible one.