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Texas Weekly: A Texas-sized Hole in the Safety Net

If the "states' rights" leadership in Texas refuses to do anything for our state, then it's up to Congress to enact reform that will benefit all Americans, especially Texans.

By Rep. Garnet Coleman
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(Ed. note: This column by Rep. Garnet Coleman ran in last week's issue of Texas Weekly, which asked four policy and legislative experts the same question: What version of health care reform would be best for Texas?)


A reporter once noted that Governor Perry, when asked a question he did not want to answer, often replied, "It is what it is." For the past nine years, that has also been the frustrating answer millions of uninsured and underinsured Texans received when they asked the governor and the state's Republican leadership, "What about healthcare?"

It's an answer of careless surrender and evidence of an underlying philosophy that is so hostile to reform. Brick by brick, the state's healthcare system has been dismantled over the years. Starting with 2003's rollback under Speaker Craddick, Medically Needy Medicaid —which prevented medical bankruptcies — was eliminated, then the rolls of the Children's Health Insurance Program (CHIP) were slashed, and damaging privatization schemes were embarked upon. It continued this session as the Republican leadership killed a bill despite overwhelming approval in both chambers that would have allowed working parents to purchase CHIP coverage for their children.

If the "states' rights" leadership in Texas refuses to do anything for our state, then it's up to Congress to enact reform that will benefit all Americans, especially Texans. The best plan for health insurance reform is one that affordably covers most uninsured Texans, preserves the insurance of those already covered and lowers health care costs.

Texas' current system has left six million Texans without health insurance. Those who can afford coverage fight every day against skyrocketing premiums, declining benefits, medical bankruptcies, preexisting conditions, and the constant threat of being kicked off their own insurance plan. Because of our dismal health standings, we have the most to gain from federal health insurance reform under consideration.

Lowering costs and maintaining affordability is essential to achieving successful reform. In 2008, an alarming 6.9 million Texans spent more than 20 percent of their income on health related costs. Due to skyrocketing insurance rates, workers are no longer rewarded with a pay raise — they have to settle for keeping their insurance.

Too many individuals can't get coverage because insurance companies use the excuse of preexisting conditions like mental illness or cancer to charge higher premiums, or deny them altogether. In a state where 10 percent of residents have diabetes and 28 percent have high blood pressure, the need for reform is paramount.

Allowing individuals to keep their insurance with them, even after losing or changing their jobs, is key. Our state unemployment rate is currently at 8.2 percent, which means that nearly 1 million Texans are unable to find work. Also important is removing the arbitrary limits that insurance companies place on annual and lifetime benefits, because our residents deserve better than being one illness or accident away from bankruptcy.

No Texan — not the insured, underinsured, or uninsured — should have to delay medical coverage because it is too costly. As Texans, we need to support a national plan because it is the best opportunity to reform the state's system.

Statistics tell a story, and being first in the nation for the number of uninsured says that there are leaders in Texas unwilling to provide healthcare to their constituents. Twenty-five percent of women aged 55-64 are uninsured. Many, who are often widows or divorced with no assistance, are waiting for Medicare to kick in on their 65th birthday to bring them the security of having health insurance once again. Another large number of individuals in need are mothers and fathers of kids on Medicaid and CHIP. These groups have fallen through the Texas-sized hole in the social safety net.

If left to this troubling philosophy, the problem will continue to grow and Texas will fall farther behind, to the detriment of its future well being. The best healthcare reform for Texas is one that rejects the failed reasoning of its recent leaders and actually attempts to solve the problem.

"It is what it is," is not a healthcare plan, and it's not a good excuse; it is a proud fanfare for mediocrity and the status quo. The current system has failed Texas families, Texas businesses, and the state as a whole. The people of Texas deserve a victory.

Rep. Garnet Coleman, D-Houston, serves in HD-147. He's on the Calendars and Public Health committees, and chairs the Committee on County Affairs.

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Health care Department of State Health Services Federal health reform Garnet Coleman Medicaid