Wendy Davis is asleep at the switch again. The Obama administration has opened a new front on the battle over Medicaid expansion. By 2016, says the White House, states that have adopted expansion will have saved $4.3 billion. In addition, expansion states would have experienced 3.3 million annual physicians' visits, 176,000 more cholesterol screenings, 44,000 more mammograms, and 97,000 fewer people experiencing depression. This ought to be a heaven-sent opportunity for Davis to distinguish herself from Abbott. Expansion would have saved Texas $3.1B in 2014, $10.4B by 2017. And yet, the state's Republican leaders are willing to allow their hatred for Barack Obama to get in the way of improving Texans' health, not to mention providing billions of dollars for doctors and hospitals.
On Friday, a joint conference committee from the House and Senate announced a budget deal for the 2014-2015 biennium. The result, assuming that it passes the full House and Senate next week, comes in at about $195.5 billion—more than last time around, and although it doesn't break the spending cap, it does allow for about $2 billion dollars to be withdrawn from the Rainy Day Fund to pay for water.
On the first morning after the long Easter weekend, state troopers and men wearing dark suits and scowls occupied the area outside the Governor’s Public Reception Room on the second floor of the Capitol. They would soon have company. I stood with a group of reporters, and we could hear the protesters heading our way, their chants growing louder as they closed in. The ennui of the morning was broken as TV cameramen raced to the stairs to film the scene.
The first day of debate over the House Appropriations bill is typically one of the most consequential events of a legislative session. Last Thursday's debate was no exception. The highlight was a school vouchers amendment by Democrat Abel Herrero, of Corpus Christi: The language of Herrero's amendment read, "Use of Appropriated Funds for School Vouchers or to Support Tax-Credit Scholarships Prohibited. Money appropriated to the Texas Education Agency by the Act may not be used to pay for or support school vouchers or scholarships for private primary or secondary education using donations received from entities using donations received from entities that receive tax credits as a result of the donations." This immediately led to a heated discussion between Herrero and Scott Turner, a freshman Republican whose district includes Rockwall County and parts of Collin County. Turner spoke with considerable emotion about the fate of children who grow up in gang-infested neighborhoods, including his own nephew.
A central conceptual problem with Texas's ongoing resistance to the federal government's effort to expand Medicaid is that while Texas's Republican leadership have a point—it would be better to spend money on an efficient entitlement program than a bloated and dysfunctional one—they haven't fully specified what a Texas approach to Medicaid would entail.
The debate over whether Texas should expand its Medicaid program is still raging. Funding the current program, though: that much we can do. The proof came on Tuesday, when the Senate passed its version of HB10, the first supplemental appropriations bill of the session. The bill, which the House of Representatives passed last week, allocates about $4.7 billion from the state's general revenue accounts to pay for Medicaid spending in the current (2012-2013) biennium.
In the end, the drama in the House resulted from a complete lack of drama. Lawmakers had been gearing up for its initial fight of the session over HB 10, a $4.8 billion supplemental appropriation that would, among other things, cover a looming Medicaid shortfall in the current budget cycle. As one lawmaker commented as he moved briskly down the aisle after the House had been called to order, “Is today the first day of real work?”
In June 2009, the New Yorker's Atul Gawande penned his famous story about health care, "The Cost Conundrum," in which he reported that McAllen was "one of the most expensive health-care markets in the country," and that when it came to Medicare specifically, costs were almost twice the national average, with the federally funded program for senior citizens paying for five times as many home-nurse visits.