Expanding Medicaid is wise fiscal policy

Expanding Medicaid is wise fiscal policy

Dade Phelan, Speaker of the House of Representatives, issued interim charges related to healthcare reform in Texas.

The House Select Committee on Healthcare Reform will meet in Austin on August 4th and 5th, 2022 to address this charge.

As the only member from the Rio Grande Valley, and vice chair of the Public Health Committee, I am honored to represent the RGV and advocate for improved healthcare access and health outcomes in our community.

It’s no secret that Texans are paying more for healthcare than the rest of the country. Texas is one of the 12 states that have failed to expand Medicaid, even after a pandemic that exposed the inequities in our state’s healthcare system. Because of Texas’ decision to limit Medicaid access, almost five million Texans are living without access to affordable healthcare, and the Valley is disproportionately negatively affected.

The need for access to affordable healthcare in the Valley is even more important because of the unique healthcare needs of our community. Obesity and diabetes rates are higher in Hispanic communities, conditions that both lead to complications with COVID-19. In Hidalgo County, 42.9% of adults are obese compared to just 29.2% of all Texas adults, according to the American Community Survey. The numbers are worse for our uninsured rate; 50.3% of adults aged 18-64 report lacking health insurance compared to 26.7% of adults in non-border counties.

I’ve long been a supporter of Medicaid expansion. It’s simply wise fiscal policy. During the regular session, I filed House Bill 1741, otherwise known as the “Texas Healthy Business Act” to expand Medicaid to those eligible under federal matching dollars. Currently, the federal government covers only 62% of our state’s Medicaid funding – which means Texans pay 38% directly. If Texas expanded Medicaid, the federal government would pay 90% of the cost, reducing Texans’ responsibility to just 10%. Expanding coverage for adults between the ages of 19-64 with incomes below 138% of the poverty level (a family of four that makes at or below $38,295 per year) is not only wise fiscal policy, but it is also a moral imperative.

We know a healthy population leads to a strong economy. Texas has both the highest number and the highest percentage of uninsured residents in the nation. Let’s get our uninsured neighbors insured through Medicaid so they can get the preventive care they need before their emergency room bills cost taxpayers unnecessary money and families are destroyed by either the death of a breadwinner or financial ruin from medical bills.

One factor of many factors that complicate healthcare costs is the lack of price transparency for office visits, hospitals visits, and medications. Imagine if you went to buy a car and did not know what it would cost you until after you had driven it off the lot? Patients in Texas deserve to know the cost of treatments and services in advance so they can make plans for their personal health as well as their economic circumstances. Price disclosure – across the board from service providers, to services provided to medication costs – would allow patients to compare the cost of treatments at hospitals and make the best decision for themselves. It would also increase competition in the market.


The Select Committee has been charged to specifically:

1. Study the implications of excessive health care costs on the efficacy of Texas Medicaid and the private health insurance market and the resulting impact on individual Texans, businesses, and state government.

2. Monitor the implementation of, and compliance with, current price transparency requirements and study ways that the state can support patients and increase competition. Make legislative and administrative recommendations, as appropriate; and

3. Evaluate innovative, fiscally positive options to ensure that Texans have access to affordable, quality and comprehensive health care, with an emphasis on reaching low-income and at-risk populations. The evaluation should include a study of strategies other states and organizations have implemented or proposed to address health care access and affordability. Make recommendations to increase primary health care access points in Texas.

You can count on me to advocate for our way of life – especially a healthy life – during this committee hearing and always.

You may watch the hearing live in person in Austin or watch it here – https://house.texas.gov/video-audio. As always, you can reach out to my office with concerns by emailing [email protected] or calling 512-463-0578.

Editor’s Note: The above guest column was penned by state Rep. RD ‘Bobby’ Guerra of McAllen. The column appears in The Rio Grande Guardian International News Service with the permission of the author. Rep. Guerra can be reached by email via: [email protected]

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