GOP Medicare Debate Continues: Why Texas May Take Its Health Into Its Own Hands


The Lone Star state is at it again: six counties in Texas are thinking of adapting county-run Medicaid expansions in response to continued conflict within the GOP over how to approach health care issues.

George Hernandez Jr., the CEO of San Antonio’s University Health System, proposed taking up on Obama’s Medicaid expansion proposal. He has already garnered support from officials in Houston and Dallas.

Governor Rick Perry, however, won’t be so thrilled with the news. His consistent antagonism toward President Obama’s health care strategy means he stringently opposes expanding Medicaid. Even though Herandez’s philosophy would save counties like Bexar (to which San Antonio belongs) over $53 million yearly, Perry isn’t looking to shift his opinion. “I will not be party to socializing healthcare and bankrupting my state,” Perry said back in July

What Perry fails to recognize is the very crisis in which average Texans find themselves. The Department of Health & Human Services rated the state’s current health care system as “very weak” in preventative measures, including those for cancer and diabetes. The state also has the highest percentage (27.6%) of residents without health insurance. Perry’s strict anti-Medicaid approach is not just misplaced; it’s impractical. Finally, at a crucial political moment, Texans like Hernandez are declaring their own thoughts on health care.

The difference in opinion between Hernandez and Perry speaks to the larger health care problems plaguing the Republican Party. While some high-ranking conservatives dismiss the idea of health care entirely (Paul Ryan, for instance, and his voucher system), others welcome the notion with open arms. As Washington Post writer Lori Stahl correctly observed, "Perry does not speak for all Texans when it comes to federal Medicaid dollars."

The question becomes this: who does speak for all Texans, or all Republicans, or all conservatives when it comes to federal Medicaid dollars? What is the overarching mindset on national health care reform? 

What’s certain is the uncertainty itself, and this will prove to be dangerous in the upcoming weeks. The New York Times recently illustrated the five categories of Republicans voters: the Main Street majority, the Christian conservatives, the Libertarians, the Tea-Party radicals, and the Disaffected. Although all five categories share that famous “limited taxes” mindset, many vary or are unclear about how to reform health care. 

With each successive story of Republicans and their Medicaid woes, I find it harder to clarify exactly how the GOP plans to address health care reform. And until the Party can engender one coherent and bipartite plan, they’ll have to get used to Obamacare for good.