Panelists discuss the future of Medicaid and healthcare policy in Texas

Mark Carrion

Heatlhcare policy in Texas will change after the passage of the Affordable Care Act, and panelists Monday focused on uncovering the future of those policies and Medicaid’s place in Texas. 

The panel included Anne Dunkelberg, from the left-leaning Center for Public Policy Priorities and Arlene Wohlgemuth, from the right-leaning Texas Public Policy Foundation’s Center for Health Care Policy. William Sage, law professor and vice provost for health affairs, moderated the talk.

“What we’re looking for as advocates is something that will establish a systematic way to affordable healthcare that will be available to all levels,” Dunkelberg said. “To make any of that work — be affordable, effective — you got to have a system of getting healthcare cost under control.”

Dunkelberg said as of 2011 there were 6.1 million uninsured Texans, a majority of them working-age adults. She said expanding Medicaid would bring $24.1 billion in federal money to Texans and insure 1.5 million more people by 2017, though three million Texans would still be uninsured.

Wohlgemuth said Medicaid needed reform, not expansion. Wohlgemuth said with the Affordable Care Act, younger and healthier people and small employers in Austin will see an increase of 162 percent in insurance premiums by 2014. On the other hand, older and sicker individuals in Austin will see a decrease of 32 percent in premiums.

“I think we have to look very seriously at actual experience rather than projections,” Wohlgemuth said.

Wohlgemuth made reference to two Medicaid expansion examples in Arizona and Maine, both of which failed to decrease the percentage of uninsured and ended up costing hundreds of millions of dollars more than expected.

“We can do better,” Wohlgemuth said. We can do better for the Medicaid patient. We can do better for the taxpayer.”

Wohlgemuth advocated a system where people make their own decisions about what to pay for in healthcare. She said that this will make people more aware of how much healthcare costs.

“The individual in charge of spending the money is going to be the best consumer,” Wohlgemuth said.

Both Dunkelberg and Wohlgemuth agreed that overall there needs to be more transparency for healthcare costs.

Ben DeMarsh, a second-year law student, attended the panel on Monday. DeMarsh is also a member of the Health Law and Bioethics Society, one of the four School of Law clubs that helped host the event.

“There’s bipartisan support for greater healthcare cost transparency,” DeMarsh said. “There’s a need for more consumer-driven medical care.”

DeMarsh said although the speakers disagreed on expanding Medicaid, people should become more actively involved with how their money is spent on medical care.

“I really believe that cost transparency is the most important aspect of anything that we can do with health reform,” DeMarsh said.

Printed on Tuesday, March 19, 2013 as: Panelists debate merits of Medicaid expansion 

This article was corrected after its original posting.