Commentary: Protect Texans’ Health and Livelihoods: Expand Medicaid Now

by the Texas Senate Democratic Caucus

As we grapple with the unprecedented global pandemic caused by COVID-19, the state must confront economic and health challenges with bold, decisive leadership.

The state has taken some positive actions. There is however, a glaring void where the state has yet to act–addressing the five million Texans who are uninsured and unable to access the testing and care they need during this crisis. Immediately expanding Medicaid would give us powerful tools to address this glaring void.

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The COVID-19 crisis shines a bright light on how fragile our healthcare system is in Texas.

It is not only Texas families who are one or two paychecks away from making ends meet; it is also doctors and other providers whom we depend to serve families across Texas. As we can see from recent layoffs at hospitals and closures of medical and dental offices, COVID-19 only increases the burden on Texas families.

Even before COVID-19, we knew that the high uninsured rate affects the insured as well as the uninsured – burdening our healthcare system, driving up premiums for families and businesses, lowering productivity and more.

In addition, many Texans who have been deemed “essential”–those who work at nursing homes, grocery stores, restaurants and many others–don’t have health insurance from their employers or otherwise.

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We know the numbers well: Texas has long held the record for the most uninsured in the nation. In the state’s urban areas, which many of us represent, about one in four lack insurance. The challenge is greater still in rural and border communities with uninsured rates up to 36 percent.

We also have considerable racial and economic disparities with minorities and the working poor having much higher uninsured rates and worse health outcomes.

Take Fort Worth’s 76104 zip code for example. 76104, where African American and Latino Texans make up over 80 percent of the population, nearly a third of the residents live below the poverty level and the zip code has the lowest life expectancy in the entire state of Texas. As more Texans lose their jobs–and their health insurance–due to COVID-19, these numbers in 76104 and across Texas will continue to increase.

It is vital to the health of all Texans and the state’s economy that we increase health care access for Texans regardless of their zip code or race. With a stroke of the governor’s pen, Medicaid expansion would immediately provide coverage to 1.5 million Texans and nearly 80,000 residents of Tarrant County.

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Economists estimate that expansion would infuse approximately $8 billion annually into the Texas economy, increase gross state product by $29.4 billion over the first two years, generate a 331 percent return on investment over 10 years and pump over $300 million annually in new Medicaid funds into Tarrant County.

It is too early to know the full extent of the economic devastation of COVID-19, but common sense dictates that we could use an extra $8 billion right now. With the anticipated economic recession from declining sales tax revenue coupled with the oil crisis, these billions of dollars would go a long way to balancing the state’s budget and reducing any temptation to increase property taxes.

Expanding Medicaid is not a Republican or Democratic issue. Thirty-six states, with leaders from both parties, have taken their own unique approaches to increasing access to healthcare for their citizens.

Ultimately, getting it right will require the sincere efforts of all Texas leaders but the governor must first use his executive authority to expand Medicaid now. Our collective well-being depends on it.

The 12 current members of the Texas Senate Democratic Caucus are Chair Carol Alvarado (Houston), Vice Chair Nathan Johnson (Dallas), Sen. Juan “Chuy” Hinojosa (McAllen), Sen. Eddie Lucio, Jr. (Brownsville), Sen. José Menéndez (San Antonio), Sen. Borris Miles (Houston), Sen. Beverly Powell (Burleson), Sen. José Rodríguez (El Paso), Sen. Kirk Watson (Austin), Sen. Royce West (Dallas), Sen. John Whitmire (Houston) and Sen. Judith Zaffirini (Laredo).

The state Senators’ districts encompass urban and rural communities across the state, representing nearly 11 million Texans. 

The Texas Senate Democratic Caucus is organized to promote legislative initiatives that improve the lives of Texans, including supporting economic development, public and higher education, health care, natural resources, criminal justice and civil rights issues.