AUSTIN, Texas - Texas has the most uninsured people in the country, but state officials have rejected an almost cost-free expansion of the federal Medicaid program.

As many as 1 million Texans fall into the coverage gap, where they don't qualify for Medicaid but can't afford health coverage through the Affordable Care Act. According to a new report, not expanding Medicaid not only affects low-income individuals but puts a major strain on the state economy.

Patrick Bresette, executive director of the Children's Defense Fund-Texas, said polls show most Texans are in favor of Medicaid expansion.

"A pretty strong majority of Texans actually think we should expand coverage," he said. "I think the latest research and a survey was 63 percent of Texans across partisan lines thought we should be expanding it. So, there's really no excuse other than some sort of a political feud with the federal government."

According to this week's report from the Georgetown University Center for Children and Families, the lack of Medicaid expansion cost the Texas economy almost $8 billion in 2015, with local governments paying another $5 billion for uncompensated care.

Report co-author Jack Hoadley said the 31 states that have expanded Medicaid have seen dramatic reductions in the number of uninsured people, millions of dollars in savings for hospitals and community health centers, and significant reductions in the cost and amount of uncompensated care.

"We heard from one clinic that said the share of uninsured patients had dropped from 51 percent of all their patients to 17 percent," he said. "So, it's really a dramatic drop, and you just don't see those same kinds of changes in the non-expansion states."

An infusion of Medicaid dollars often causes a ripple effect in state health-care systems, Hoadley said, expanding coverage, bringing new programs and improving care, particularly in rural areas. Under the Affordable Care Act, states are eligible to expand Medicaid at no cost through 2016, with a 90-10 federal-local cost-share beginning in 2020.

The report is online at ccf.georgetown.edu.


get more stories like this via email

Despite uncertainty about Medicaid funding in Congress, Tennessee is moving ahead to help improve people's health outcomes with a program for community health workers.

Tennessee's Medicaid program, TennCare, is partnering with the Tennessee Community Health Worker Association to offer an accreditation program to promote best practices for training and supporting the workforce.

Nikayla Boyd, executive director of the association, said community health workers link people to care and promote healthy habits. She noted the pilot accreditation program is underway, with a full launch expected by 2027.

"In addition to CHWs having individual certification, we are also accrediting the actual CHW program," Boyd explained. "Accrediting that program, that organization, that employer."

TennCare will fund grants for up to 14 organizations to complete the accreditation process. There are about 600 community health workers in the state, according to the U.S. Bureau of Labor Statistics, but Boyd argued more are needed.

Boyd pointed out they partner with the National Committee for Quality Assurance to design the accreditation programs. Some are centered on specific diseases, while others primarily address the social determinants of health.

"To date, we have six programs in Tennessee that have been accredited," Boyd outlined. "Two at Methodist Le Bonheur Community Outreach, two at Siloam Health, one at Regional One Health and then, another at the Mental Health Cooperative."

Boyd added an organization must meet seven standards in order to be accredited. For those working with community health workers, they include the full scope of training from recruitment to evaluations, support and supervision.


get more stories like this via email

Republican lawmakers are considering billions of dollars in cuts to Medicaid. But a new report finds those spending cuts might impact health-care coverage for thousands of Maryland military families.

The report by the Georgetown Center for Children and Families finds more than 850,000 people enrolled in Medicaid have military health insurance, known as TRICARE, as their primary coverage. One in 10 children of service members with TRICARE is also enrolled in Medicaid.

Joan Alker, executive director of the Georgetown University Center for Children and Families, said Medicaid is important for service members with children who require more intensive health care.

"The TRICARE benefit package just isn't enough, so Medicaid is making TRICARE work for those families by covering the high cost of services and some benefits that those children otherwise would not have access to," Alker explained.

Republicans in Congress are trying to reel in what they view as out-of-control spending by $2 trillion in the next budget. But cuts to Medicaid are not universally agreed upon among Republican lawmakers.

Medicaid also serves 40% of children in the U.S. with a benefit that allows them to receive preventive and ameliorative care. That benefit began after a military report in the 1960s found young men were not qualified for military service in Vietnam because of preventive medical issues during their childhoods.

Retired Army Brigadier General George Schwartz said Medicaid cuts could have a negative impact on recruiting numbers as well. If troops lack proper coverage for their families, he thinks they may seek other career paths that can provide that coverage.

"As those young people reach the age where they're eligible for military service, the military is competing with private industry and all sorts of organizations for these young people. From a mission readiness point, this is a matter of national security," Schwartz contended.

Maryland is home to more than 100,000 active-duty service members and more than 35,000 military-connected children in the state.

With Mother's Day coming up, some Pennsylvania lawmakers are backing a set of bills that could help improve maternal health.

The Black Maternal Health Caucus introduced the updated "PA Momnibus 2.0" package in April, focused on tackling disparities in maternal health care by improving access to services.

Black women in the state are nearly twice as likely to die from childbirth complications. Rep. La'Tasha D. Mayes, D-Allegheny County, said 93% of maternal deaths are preventable.

"All the bills are for all moms, and because we know when we fix and address and take on maternal mortality and morbidity for Black moms, we solve it for every mom and birthing person in the Commonwealth," she explained.

The nine-bill package builds upon a 2024 "Momnibus" introduced by Mayes and Reps. Morgan Cephas and Gina Curry, both Republicans. Mayes said the caucus is working towards moving the bills toward votes, and then action in the Senate.

Two of the measures would expand access to blood pressure monitors and ensure they are covered through private insurance and Medicaid. Mayes added another measure would expand the reach of midwives, who provide care throughout pregnancy and childbirth, as well as postpartum.

"The Midwifery Practice Innovation bill that's going to help us advance midwifery as an occupation in this commonwealth, because it's very challenging to become a midwife, as well as be able to practice fully in a way that can serve moms," she continued.

The "Momnibus" also includes supports for nursing mothers, and invests in a Maternal and Newborn Supply Kit program, and maternal-health deserts. Mayes says more than 12% of women have no birthing facility within 30 minutes of their home, and Black women are three times more likely to die during or after birth compared with other women.