Medicaid Expansion Down But Not Out
with Nine GOP Co-Authors on House Bill

Capitol Inside
April 22, 2021

All of the Texas House Democrats and one Republican colleague voted on Thursday for an expansion of Medicaid statewide in a state budget amendment that none of the other GOP representatives supported.

The House shot down the proposal in a vote of 80-68 with State Rep. Lyle Larson of San Antonio as the only Republican on the losing side. Veteran State Rep. Garnet Coleman of Houston had most if not all of his fellow Democrats gathered around him when he made a pitch for the amendment during the marathon debate on a state spending plan for the next two years.

But the vote that killed the Coleman amendment didn't necessarily signal an end to battle on Medicaid in the Legislature's lower chamber. The Democrats still could have a better than average chance of winning the war on an expansion of the federal health care program for the poor and elderly with a bill that appears to have a good shot to pass with nine GOP representatives curently listed as co-sponsors.

That's the exact number of Republicans that Democratic State Rep. Julie Johnson of Dallas would need to pass House Bill 3871 if all of the House's 67 Democrats are on board as expected.

GOP leaders and lawmakers have refused to expand Medicaid under the terms of the Affordable Care Act that Democrat Barack Obama persuaded Congress to pass in his first term as president. The Republicans have offered no congent explanations for their opposition which has cost the state billions of dollars in federal matching money every year.

But Governor Greg Abbott and the Republicans here find themselves backed into a corner after learning late week that the U.S. Health & Human Services Department that Democratic President Joe Biden controls had rejected a 10-year extension of the Texas Medicaid waiver because Donald Trump's administration hadn't run it through the proper channels.

Texas could be forfeiting as much as $15 billion in federal funding in the next fiscal year alone without legislation that would accomplish essentially what the defeated amendment sought to do without calling it an expansion of Medicaid.

GOP State Rep. Giovanni Capriglione of Southlake made a compelling case against the Medicaid amendment on the grounds that it involved a subject that's too complex to be rushed into law without a full vetting and public hearing. Capriglione is the chairman of a subcommittee that oversees health and human service spending in Article II.

But Capriglione didn't challenge the substance of the Coleman amendment - and that could be a positive sign for the Johnson bill's odds.

HB 3871 had been parked for more than a month in the Human Services Committee without a date at this point for a hearing or a vote. Democratic State Rep. Jarvis Johnson of Houston is the author of an identical bill that has two Democratic co-authors but no Republicans signed on at this point.

more to come ...