“A broad spectrum of people across business, faith and health care communities are coming together to ask that we find a way to draw down these federal dollars, and I think it's imperative that we do,” said Judge Clay Lewis Jenkins, chairman of the Dallas County Commissioners Court.The Dallas Area interfaith coalition helped develop this resolution, and has been working with county activists across the state to pass these resolutions. They have some political heft in the form of support from the Texas Hospital Association and the Texas Medical Association. The El Paso County Commissioners Court adopted a similar resolution on Monday, and officials in Bexar, Harris and Hidalgo counties are considering resolutions this week. Not that it's likely to sway Gov. Rick Perry. A spokesman says, "Counties can bring this before lawmakers, but the governor does not want the state footing the bill. For this to even be considered, counties should have to face paying the entire cost of the program without state tax dollars."
In 2011, local Texas governments, cities and counties, spent $2.5 billion in unreimbursed health care costs, according to a report by Billy Hamilton, the state's former deputy comptroller and former chief revenue estimator. If Texas expanded Medicaid coverage to impoverished adults in 2014 under the Affordable Care Act, the state could receive an additional $100 billion in federal dollars over 10 years, helping to offset that spending by local governments. The state would pay $15 billion during that time, which opponents of the expansion, including state Republican leaders, argue is too much.
This issue could become a salient one for 2014 elections, with the organizing coalition that's developing behind it. There is no deadline for states to accept Medicaid funding, they can opt in at any point. While the offer of 100 percent funding from the federal government is available only through 2016, states can still have the majority of the tab picked up by the feds long after. So the next state legislature and the next governor could reverse course and do the right thing.