Lawmakers Target Federal Health Reform

Federal health care reform was the clear antagonist at today’s meeting of the House Select Committee on State Sovereignty. Republican lawmakers laid out a dozen bills — and a handful of different strategies — to prevent implementation of the Patient Protection and Affordable Care Act in Texas, and allow the state to operate Medicaid its own way.

“How nice it would be if we were an independent republic again,” opined Dr. Steve Hotze, who heads Conservative Republicans of Texas and runs a health and wellness center in Houston. Hotze said the federal government has no authority to impose upon Texans what kind of health coverage to buy, and shouldn’t be “sticking its finger in our pie.”

Rep. Trey Martinez Fischer, D-San Antonio and the committee’s vice chairman, countered: “If I help you stop the mandate, what are you going to do to help my constituents who want that health care, but just can’t get it from the state or their employer?”

One bill proposed today, state Rep. Leo Berman’s HB 297, R-Tyler, would make it a criminal penalty for anyone to try to implement federal health reform in the state. The bill would “make the federal act invalid in the state of Texas,” Berman said.

Four bills and two constitutional amendments would ban the individual mandate, the tenet of federal health reform that requires Texans to have health insurance.  

“The federal mandate we have before us … puts a cost burden on cash-strapped Texans by forcing them to pay money they may not have,” said state Rep. Brandon Creighton, R-Conroe, who chairs the select committee.

“It is our job to represent the will of the people … by passing a law which protects the citizens of Texas’ right to make their own health care decisions,” added state Rep. Ken Legler, R-Pasadena.

And two bills, including Republican state Rep. Lois Kolkhorst’s HB 5, would create an Interstate Health Care Compact, in which Texas would join with other states to ask the federal government for permission to run their own health care systems — and for federal block grants to do it. Interstate compacts, effectively an effort to free states from the rules and confines of Medicaid, are on the table in at least eight other states.

Kolkhorst admits she has sleepless nights over "asking permission from the federal government, from the United States Congress, to give us our money and let us see if we can do a better job." But she said the path Texas is on with Medicaid "cannot be sustained." 

Rep. Tryon Lewis, R-Odessa and the author of the second compact bill, called the current state-federal Medicaid program a “terrible partnership,” one in which Texas has “a lot of obligations, but not a lot of control.”

But critics say the compacts are a vehicle for political rhetoric — not policy. Rep. Garnet Coleman, D-Houston, released a statement saying using an interstate compact to solve Texas’ Medicaid troubles is an unworkable solution based on “alternate realities and political ideologies.”

“We can choose to lead Texas with responsible public policy or become mere supporting actors in a national political sideshow,” Coleman said.  

Republicans on the committee acknowledged that, regardless of what they pass, federal health care reform is headed for the U.S. Supreme Court. Some, including Dallas Republican Rep. Dan Branch, cautioned against doing anything rash that could conflict with that ruling.

“Should we here in Texas let the federal process work,” he suggested, “and should we allow the judicial branch now to make an interpretation of the statute and its constitutionality?”