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Texas Voters Want Healthcare Solutions, Just Not Obamacare

Despite tepid support for the Affordable Care Act, voters want policy changes


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Texas voters aren’t big fans of the Affordable Care Act, but that doesn’t mean they don’t want politicians to solve our healthcare problems. That’s according to an election poll by Houston Public Media and KHOU in Houston.

The poll asked Texans what Congress should do about the Affordable Care Act.

“Very few like it,” concluded Bob Stein, a political science professor at Rice. He conducted the poll.

“The choices here were: Which would you rather your representative in Congress do when it comes to Obamacare? Leave the law as it is? Nine percent. So nobody seems to like the law. But only 21 percent want to repeal it.”

The majority, 62 percent, said they want to improve the law or replace it with something else. The breakdown was about half and half, with 31 percent of voters saying Congress should “improve” the law, and 30 percent saying to repeal it, but replace it with something else.

The overall trend, according to Stein, is that voters realize there are problems in our healthcare system, and Congress will have to do something.

“They’re going to have to address Obamacare in terms of ‘What are we going to replace it with?’ Repealing it will not, I think, meet the public’s expectations,” Stein said.

The poll also asked if Texas government should change spending on the uninsured.

Forty-four percent of likely Texas voters said to spend more, and an additional twenty-six percent said to maintain current spending.

Only sixteen percent said to spend less on the uninsured.

That’s exciting news, according to Dr. Claire Bocchini. She leads Doctors For Change, a Houston healthcare advocacy group.

“I think [it] means that people get it,” Bocchini said. “People get that being uninsured is a big problem and that as a community we need to keep each other healthy for the benefit of the entire community.”

But the poll didn’t ask voters what exactly Texas should do about the uninsured.

Texas Republicans have opposed expanding Medicaid — even though the federal government would pay 90 percent of the cost. One reason for the opposition is that the expansion of Medicaid was originally part of the Affordable Care Act, although later the U.S. Supreme Court ruled states could opt out. Texas was among 23 states that have so far declined to expand Medicaid. Expansion would extend the tax-payer funded insurance to any uninsured adults who earn less than 138 percent of the federal poverty level, and don’t have insurance through a job.

State Representative John Zerwas is an anesthesiologist and a Republican from Fort Bend County. He has been a leader in trying to create a “Texas solution” for the adults in Texas who still lack insurance.

Zerwas acknowledged that Texas Republicans typically dislike Medicaid, calling it a “broken” entitlement that doctors increasingly reject, but he said Texas shouldn’t turn away those federal dollars. If Texas implemented the expansion, it would draw down federal dollars that would inject $100 billion into the Texas economy over a decade, he said.

“A 90 percent match in perpetuity for this expansion population is a pretty generous match,” Zerwas said. “We don’t find it in a lot of programs out there.”

Zerwas and others have proposed taking that money but crafting a new program, the so-called “Texas solution,’ that would be more like private insurance instead of Medicaid. Low-income patients might be subject to co-payments, for example. That might be more politically palatable to Republicans, but the federal government would also have to approve any changes to the traditional Medicaid program.

Zerwas said more business associations in Texas, Chambers of Commerce, and city and county officials are joining the call to do more for the uninsured.

“There’s a very strong argument for doing this,” Zerwas said.

Nevertheless, he isn’t sure such a bill would pass the Legislature and won’t say yet whether he’ll introduce one. He said the conversation will take place after the November elections.

Two years ago, a bill to craft a “Texas solution,” backed by Zerwas and Democratic representative Garnet Coleman, never made it out of committee.