Statement on Expanding Medicaid–Texas Can Make a Good Deal

(AUSTIN, Texas)–April 1, 2013–The Center for Public Policy Priorities Associate Director Anne Dunkelberg made the following statement in response to questions raised by our state leadership about expanding Medicaid:
“All Texans deserve quality, affordable health care, and expanding Medicaid under the Affordable Care Act provides Texas with an opportunity to dramatically reduce the number of Texans without health insurance.
“Federal law gives Texas unprecedented flexibility when it comes to providing health care for these newly eligible adults, most of who are working but cannot afford health insurance.
“As Texas considers how to expand Medicaid to cover this new group and how to best maintain our current Medicaid program, we must focus on two simple principles:

  1. Out-of-pocket costs for Medicaid’s below- and near-poverty Texas population must be reasonable and affordable.
  2. Health benefits for the new eligible adults must equal those required for private commercial insurance available in the marketplace.   

“If we stick to these two principles, we can develop a program with the federal government that works for Texas.
“Texas has already made great strides in reforming our existing Medicaid program.  For example, Texas is building a wide range of systems to improve the quality, safety, and cost-effectiveness of care through our 1115 waiver approved in 2011.  This waiver has allowed us to fully maximize private HMO coverage of Texas current Medicaid beneficiaries, while also nearly doubling the amount of federal funding available for the 1115 waiver’s Medicaid reform goals. Texas has now maximized market engagement by having virtually all Texans in Medicaid get their care through private HMOs.
“We can do even more going forward.  For example, both federal and state regulations allow Texas to enact co-payments across the entire Medicaid population.  CPPP supports such a move as long as it keeps out-of-pocket costs affordable as defined in federal law.
“Other conservative states are leading the way in striking bargains with the federal government to tailor programs that work for their states.  Texas can reach a win-win agreement too.   All Texans should call on our state leadership to embrace this historic opportunity to expand Medicaid to dramatically increase the number of Texans with health insurance.  Doing so will save local tax dollars, be a boon to our economy, and, most important, be a huge step toward providing all Texans with access to health care.”
— CPPP —
About CPPP
The Center for Public Policy Priorities is a nonpartisan, nonprofit policy institute committed to improving public policies to make a better Texas. You can learn more at
Alexa Garcia-Ditta
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