IN OUR VIEW | Medicaid Expansion: Texas House rejects proposal to increase income restrictions

Texas has long been one of the more restrictive states with its Medicaid program.

Medicaid is intended to provide health insurance for Americans who can't afford it. Eligibility is based on income and, in Texas, other factors including age, disability and dependents. Most Texans on Medicaid are children and most of the rest are living on 14% or below the federal poverty guidelines. Adults under 65 with no disability or without dependents do not qualify.

As part of the Affordable Care Act, President Barack Obama offered funds to help states expand Medicaid eligibility to those earning up to 138% of federal poverty standards. Arkansas is among the states that took up the offer. Texas Gov. Rick Perry famously spurned it as a stand against "Obamacare." But he did quietly take federal money under the "1115 waiver," which provided funds to hospitals to help pay for the uninsured.

Today, only 12 states have not expanded Medicaid eligibility. And many expected that number could soon go down by one.

The current 1115 cash flow is probably coming to an end next year. So the Texas House of Representatives considered a bill Thursday that would keep billions in federal 1115 funds to essentially expand Medicaid eligibility - and allow the state's conservative leadership to design how to do it. It looked like there were enough votes to pass it.

Looks can be deceiving. The House voted it down, 80-68.

Texas has the highest rate of residents without medical insurance in the U.S. That's a disgrace in a state that proudly claims to be an economic example for the rest of the country. Rejecting Medicaid expansion keeps a tremendous burden on low-wage working Texans who are trying to make ends meet but struggle without health insurance.

And with the potential loss of 1115 waiver funding, lawmakers had better come up with something soon. Texas' Republican leadership has been taking federal funds under a provision of the Affordable Care Act for a decade, while putting on a show of rejecting Obamacare. But it looks like they won't have it both ways for much longer.

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