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CON: State should be able to reform Medicaid on its own

By JR Ortega
Sept. 22, 2013 at 4:22 a.m.

Arlene Wohlgemuth

From State Rep. Geanie Morrison, R-Victoria

"If ever there was a time to adhere to the 10th Amendment, now is the time. States need to fight this because this is a federal mandate that is contrary to the United States Constitution.

"We knew this mandate was on the horizon, so a majority of the Texas House voted three times to reject the expansion of Medicaid because of the cost in the out-years.

"A report during the 83rd Legislative session from the Legislative Budget Board put a fiscal note on a bill to expand Medicaid of $50 million in general revenue funds and $4 billion in all funds for the 2014-15 biennium.

"There was about $29 billion spent on Medicaid in 2012, and it is estimated that $6 billion was fraudulent.

"We need additional Medicaid reforms to eliminate fraud. Texas cannot afford a Medicaid expansion."

Nicki Lowry does not see eye to eye with the Obama administration on many issues, but the Affordable Care Act is definitely one of the biggest.

The Victoria mother has even stood alongside the road with others protesting to impeach President Barack Obama on several grounds, including the act.

"It should have never been passed," she said.

Though Lowry's disagreement is with the entire act, she also does not support the expansion of Medicaid, saying the act as a whole is slowly turning the country socialist.

"My fear is that we are no longer going to recognize the free America," she said. "We have sure made a mess of things."

Lowry would rather privatize health care than leave it in the hands of the government.

Arlene Wohlgemuth sees two critical points to why expanding Medicaid would not work: The health outcomes have proven to not be better than for people who are uninsured, and there is plenty of fraud and abuse of the Medicaid system already.

Wohlgemuth, the executive director and director of the Center for Health Care Policy, which is part of the Texas Public Policy Foundation, does not support expansion, and neither does the foundation.

"Why expand a failed program?" Wohlgemuth asked.

Wohlgemuth said she has seen studies from several states in which controlled groups of people placed on Medicaid spend more dollars, and it far outweighs what was projected to be spent.

Those same studies, as well as others, show about half of those on Medicaid are "no shows" at clinics. Instead, they still flood hospitals for primary care, Wohlgemuth said.

What Wohlgemuth would like to see is a block grant, which Gov. Rick Perry mentioned in a letter to Texas' Health and Human Services Commission last week.

In a block grant, the federal funds would come to the state, and in turn, the state will reform its own Medicaid. Wohlgemuth recommends a sliding-scale Medicaid based on income.

Right now, users of Medicaid do not pay anything up front.

"The things we value in life are the ones we have been spending our own money on," she said.

People need to research and understand the law before picking sides, said Victoria resident Randy Beltran.

Beltran, 34, said he does not like the idea of the government handling his health insurance.

Like Wohlgemuth, Beltran said an expansion of Medicaid does not give the poor a chance to value their health insurance because they are not paying.

Beltran said an expansion could "poison" the younger generation.

"You get to where you are through hard work and determination. This is America; this is where you can do it," he said.

Wohlgemuth said while the debate on expanding Medicaid is a heated one, the bottom line is reform has to happen, but the act is not the way to do it.

"The people of Texas want to help people less fortunate," she said. "But they want a value for their tax dollars."

PRO: Expansion would give state billions in funding, thousands of jobs

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