Child Health

“Let’s talk about it:” Dr. Anderson champions Medicaid expansion to House Insurance Committee

March 7, 2019 | Texas

My name is Dr. Cheasty Anderson. I am the Senior Policy Associate in the Texas office of the Children’s Defense Fund. I am here to testify in support of Rep. Coleman’s HB 565, proposing that Texas expand our Medicaid program and codify the Affordable Care Act into Texas state law. Today specifically, I’d like to present arguments in support of expanding access to health insurance to the low-income adult population in Texas. We appreciate the committee’s focus on federal health care policy, and how we can best administer our program here in Texas.

CDF Texas has been working diligently for more than 17 years to ensure that all the children of Texas have a good start in life and a successful passage to adulthood with the help of caring families and communities. We have offices and programs in Austin, Houston, East Texas and the Rio Grande Valley.

As members of this committee are aware, Texas has both the highest rate and number of uninsured adults and children in the country, and these numbers have begun to climb, after years of steady decline. We submit into the record this one-pager, produced by the Cover Texas Now coalition, which outlines the gravest threats faced by both the state of Texas and the people of Texas, as relates to our high uninsured rate. For those members of this committee who are new to health insurance, I’d like to offer the reminder that our current Medicaid program, with very few exceptions, does not cover adults. The people who fall into our uninsured population, which we call the coverage gap, are largely low-wage workers, students, and caretakers. They are daycare workers, truck drivers, construction workers, house cleaners, restaurant workers, stay at home moms, and other similar jobs. These are people upon whom our economy relies, and yet they have no access to health insurance of any kind.

So this is the context. I want to ask this committee to take into consideration recent polling data, which found that 87 percent of Texans believe that increasing access to health insurance is either a top priority or important, and that 64 percent support Medicaid expansion. These poll results are similar to findings in other Texas polls, and correlate with data that consistently show healthcare being one of the top three voting issues for Texans. Texans are very concerned about our dire health care situation, and the reason they are concerned is because it impacts so many of them personally.

In fact just yesterday, a rally on the steps of this Capitol building drew advocates from around the state to advocate for the right to vote on this issue through a ballot initiative, if the Legislature refuses to act. These Texans came because they don’t want their rural hospitals to shut down for lack of funding. They want working-class parents to have health insurance – they all know that healthy children start with healthy parents. They want college students to have health insurance. They want that health insurance to be comprehensive and affordable, and to cover substance use, mental health, maternal health, and pre-existing conditions. They want everybody to be able to afford the medication they need and to get treatment for cancer before it spreads. They want their families to be at much lower risk of medical bankruptcy. They want to end the maternal mortality crisis. These items are things that, in all likelihood, every member of this committee does not worry about, personally, because every member of this committee has high quality affordable health insurance. But these items are things that your constituents worry about, day after day, year after year.

We understand that after years of divisive politics, a vote on this is something of a political litmus test that certain members are leery of taking. But consider that we are not asking this committee, right here and now, to decide that Texas will do a Medicaid Expansion. We are asking this committee to pass this bill into the House so that we can have what is long overdue – a thorough and wide-ranging debate on this question. To have a vote in which members can receive meaningful feedback from their constituents and then vote in accordance with their will.
Texans are nearing a crisis point. Our child uninsured rate is more than double the national average. Our adult uninsured rate is the highest in the nation – a state of affairs that has a deleterious impact on our economy, our health care infrastructure, our workforce, and our social contract. For this body to do what it is intended to do – to tackle big problems, to asks hard questions, and find the right solution, we must consider all of the options, and we have thus far entirely failed to do this with regard to our uninsured problem. Let this be our opportunity to say that finally the Texas Legislature will have a good-faith conversation about what to do. This bill offers one possible solution available to us. Let’s talk about it.