Friday, April 05, 2013

Texas House head-fakes on Medicaid expansion

Buried in the good news about the death of school vouchers coming out of yesterday evening's state budget marathon is the sad fact that House members passed -- and later rescinded -- consideration of a discussion about the possibility of Medicaid expansion.

If that description sounds convoluted, it's because the debate in Austin was also. To Olivia Messer of the Observer...

For a brief few hours on Thursday, members of the Texas House endorsed a version of Medicaid expansion—or at least some parameters for it—but then changed their minds.

The title of that piece has the words "flip-flop" in it. Which is an appropriate description of what happened.

As Becca Aaronson of the Texas Tribune reported, the amendment wouldn’t have even directed HHSC to expand Medicaid. Rather if the state negotiated with the Obama administration to expand eligibility, the amendment said, Texas would’ve had to reduce “uncompensated care costs, [promote] the use of private insurance plans and health savings accounts, and [establish] wellness, cost-sharing and pay-for-performance initiatives. It also called for creating customized benefit plans for different Medicaid populations. The Legislative Budget Board would have been charged with determining whether such a deal addresses those reforms.”

The House initially approved the amendment Thursday afternoon. But just a few short hours after the amendment passed, Rep. Geanie Morrison (R-Victoria) proposed that the House reconsider the vote. Though Morrison initially voted in favor, she later argued vehemently that she hadn’t been “clear on what the amendment does” and that other Republicans had been similarly confused. “I want to have a discussion and then make the decision.”

The amendment was sponsored by Burnham, the lower chamber's most progressive member, and supported by Republican John Zerwas, whom I have written about previously.

House Democrats and Republicans both rose to defend the measure and to prevent reconsideration—the parliamentary version of a do-over. Rep. Trey Martinez Fischer (D-San Antonio) said, “What we’re doing here might be the most we’re ever going to do on [Medicaid].” Burnam pointed out that the measure was actually quite similar to language  Sen. Tommy Williams (R-The Woodlands) had proposed for the Senate version of the budget (and which was approved) two weeks ago. Rep. John Zerwas (R-Simonton), who collaborated with Burnam on the amendment, took to the microphone to clarify that “it’s really not a Medicaid expansion at all.”

Rep. Craig Eiland (D-Galveston) said that the amendment would certainly not ensure passage of Medicaid expansion, since Gov. Perry has so clearly opposed it anyway. “The governor has stated quite clearly that there will be no Medicaid expansion as is proposed,” he said. “If he ever tells you that he will veto something, it’s not a threat, it’s a promise.”

Even still, the floor voted 93-54 to reconsider the amendment.

I'd really like to know the backstory here. I'm going to speculate that somebody (-bodies) got bum-rushed by the governor or some of his hoods at the right-wing think tanks. I can't tell from the coverage how many members voted to approve the amendment initially and then switched their vote, but that will eventually be revealed.

As Burnam notes, the proposal remains in the Senate's version.

“It’s still in the Senate amendment,” Burnam said. “It’ll go to conference and people will talk about whether we remain open-minded and try and figure out a way to work with the national government that’s throwing out some of this money or do we just kiss it off?”

But the stench of ignorance hangs in the air like a... well, you know.

When asked if he bought the argument that Republicans truly didn’t understand what the amendment was about, Burnam said, “Unfortunately, that’s right. Unfortunately, they’re so closed-minded and bigoted and so not understanding about Obamacare that they just went along because the leadership was for it.”

So it seems that what we have here is legislators taking a vote on something that they apparently didn't fully understand. And when they got whipped by the "Obamacare is eee-vil" thugs, then they suddenly got themselves back in the far right line. So now, Medicaid expansion will probably die a slow death in some back committee room. That's a metaphor for what's going to happen to the poor, ill Texans who can't afford to get healthcare as it stands. This is the outcome I both dreaded and predicted.

Congratulations to the advocates of Texas education on finding some sanity in the Texas House with respect to vouchers. But as for the po' folks... too bad for you.

I suppose they should hire better lobbyists in the next session.

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