Abbott Appointee Endorsed Medicaid Expansion

Gov.-elect Greg Abbott’s pick for Texas secretary of state voted for a local resolution last year endorsing the expansion of Medicaid — a central tenet of the federal Affordable Care Act that Abbott fiercely campaigned against.

In a phone interview, Carlos Cascos, a Republican judge from Cameron County, said that as secretary of state he was “not just going to go along to get along” with Abbott, and that on health care issues there would be “policy disagreement” among Republican officials.

Last year, when Cameron County officials endorsed expanding Medicaid, Cascos told NPR, “It's contrary to what the leadership in Austin is recommending, but we thought it was important enough to take a position." 

On Thursday, Cascos qualified his support for extending Medicaid coverage to more than 1 million low-income Texans, saying, “At the time, I was looking at it from a local perspective in terms of the uninsured we have here in the [Rio Grande] Valley.”

Though his role as secretary of state will center on voting issues, not health care, Cascos said that if Abbott asks for an opinion on Medicaid expansion, “I will provide it.”

On the campaign trail, Abbott criticized Democratic challenger Wendy Davis for her support of expanding Medicaid, deriding it as an expansion of “Obamacare.”

“Taxpayer-funded support for the state’s safety net for poor and low-income Texans is generous and extensive,” Abbott wrote in a health policy proposal that called for a federal block grant to reform Medicaid as Texas leaders see fit.

When Abbott named Cascos, a former Democrat who switched parties in 2006, as his pick for secretary of state, Cascos said the selection demonstrated Abbott’s “commitment to the Rio Grande Valley and our border region."

Representatives for the Abbott campaign did not immediately respond to a request for comment on Cascos’ position on expanding Medicaid.

Lawmakers considered an alternative “Texas solution” to Medicaid expansion during the 2013 legislative session — an initiative that would have called on the state's health agency to seek a waiver from the federal government to draw down funds to cover the uninsured. That proposal failed.

On Wednesday, a board of medical professionals appointed by Gov. Rick Perry called on lawmakers to seek federal money to extend coverage to the poor and uninsured if and when they revisit the issue in the 2015 legislative session.

Cameron County is not alone in its endorsement of a Medicaid coverage expansion under the Affordable Care Act. In August, judges from Bexar, Dallas, El Paso, Harris, Tarrant and Travis counties penned a letter asking state Sen. Charles Schwertner, Republican of Georgetown and chairman of the Senate Health and Human Services Committee, to support a “uniquely Texas solution” to provide health coverage to the poor using federal Medicaid expansion funds.

This story was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.