House OKs Bill to Seek Federal Medicaid Waiver

The Texas House passed a bill today to take control of Texas health care reform. Representatives tentatively passed HB 13, a special session bill that will allow Texas to petition the Obama administration for a block grant to operate the Medicaid program, which insures poor children, the disabled and impoverished adults.

The author of the bill, Rep. Lois Kolkhorst, R-Brenham, commended President Barack Obama for creating a provision in the federal Patient Protection and Affordable Care Act to allow “innovative waivers.” She said a waiver could potentially give Texas the “flexibility to tailor-make” health care reform.

The bill enlists the Health and Human Services Commission, which operates the state Medicaid program, to “actively pursue” a federal Medicaid waiver. Under the provisions of the bill, an oversight committee will be set up “to facilitate the reform waiver efforts.” The committee will design and develop the waiver and facilitate the transition if the federal government accepts the waiver. But that's a big "if."

It’s unlikely the Obama administration will approve such a blanket waiver. Rep. Sylvester Turner, D-Houston, asked Kolkhorst if she really believed the Obama administration would approve such a waiver in Texas when many people are currently not getting care.

Federal health care reform law prevents states from raising eligibility requirements or decreasing the health care benefits the state currently provides, which Texas could potentially do to save money if the waiver is accepted. But Kolkhorst said that was not the intention of applying for a waiver. 

The waiver would also allow the state to introduce co-payments, which supporters of the bill say would create “a culture of personal responsibility and accountability” and encourage indigent persons receiving Medicaid to switch to the private market.

Opponents say a waiver would dramatically decrease the amount of federal funding Texas receives for state health care programs and reduce the number of people Texas could cover. Rather than receiving federal matching funds for the amount Texas pays, the state would receive the same amount for the next five years, which would not account for population growth or inflation. The opponents say, “It can only be assumed that any waiver would seek to lower the income threshold and deny coverage to Texans.”

The bill passed the House with a vote of 97 to 25. If it also passes the Senate with at least a two-thirds vote, the bill will take immediate effect.