Texas Legislature Again Says No To Medicaid Reform But Agrees To Spend More On Other Health Problems

For the second time in two years, Texas lawmakers decided against expanding Medicaid to low-income uninsured adults. But the legislature did approve additional spending on some other critical health issues, including mental health programs, rural and safety-net hospitals, and medical residency programs that train future doctors.


Texas has about one million uninsured adults that could be covered through an expansion of the government Medicaid program. But the state has to set it up.

During the 2013 legislative session, Republicans said no to that option. This time around, the same thing happened.

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State Senator Sylvia Garcia, a Houston Democrat, said it wasn’t even discussed.

“Leadership just decided we’re not going to talk about it, we’re not going to bring it up, none of the bills that dealt with that topic were even heard in committee. So they pretty much just shut it up. And for many of us, that hurts.”

Lawmakers also effectively cut some payment rates for doctors and therapists who participate in the Medicaid program.

Medical groups like the Texas Medical Association warned that might encourage more doctors to stop accepting those patients, in a state already facing a shortage of Medicaid providers.  

But some health problems got more state money. Lawmakers voted to spend an additional $150 million on mental health care. They increased funding to rural and safety-net hospitals, and they took action on the state’s doctor shortage, sending more money to medical residency programs across the state. Doctors tend to practice in states where they complete residency.


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