Sebelius hopeful for Medicaid expansion in Texas

Published on Friday, 20 December 2013 19:05 - Written by By Juan A. Lozano, Associated Press

HOUSTON (AP) — Health and Human Services Secretary Kathleen Sebelius said Friday she remains hopeful Texas will expand Medicaid coverage as part of the implementation of the Affordable Care Act.

But Democratic lawmakers who joined Sebelius in Houston to promote the health care law's rollout said they expect Texas will continue to reject expansion and fight the law's implementation in general, including through a proposal for new rules for "navigators" — workers trained to walk people through the enrollment process for insurance.

"Absent Medicaid expansion, there will still be millions of Texans that will not have affordable options for themselves and their families," said Sebelius.

The state's GOP-controlled Legislature and Republican Gov. Rick Perry opted not to create a state-run insurance marketplace and declined to expand Medicaid to cover more of the working poor.

About 14,000 Texans enrolled for insurance coverage in October and November on the federal online exchange. Coverage under these new insurance policies was to begin Jan. 1. Texas — which has the largest percentage of uninsured residents in the country — has about 6 million people who are uninsured, about a quarter of the state's population.

Sebelius said her agency intends to continue discussing Medicaid expansion with Texas leaders. But she did not offer specific details.

In a written statement issued later Friday, Health and Human Services spokesman Fabien Levy said his agency welcomes "continued conversations with Texas about developing a state-based solution that meets both the state's unique needs and the requirements of the Medicaid program."

Lucy Nashed, a spokeswoman for Perry, said Sebelius' comments amounted to "empty rhetoric."

"The governor and Texas lawmakers have been clear that we are not interested in expanding Medicaid," she said in a written statement. "If the secretary was interested in working with Texas, she would grant us the flexibility we need to implement meaningful reforms to our existing Medicaid program, rather than forcing more people into a failing system."

Perry directed the Texas Department of Insurance earlier this year to implement rules for navigators that he said would protect Texans, including requiring the workers to complete an additional 40 hours of state training, pass more exams and submit to regular background checks while on the job.

Some lawmakers and supporters of the Affordable Care Act have said the new rules for navigators are obstacles designed to fight the rollout of the health care law.

Dozens of supporters of the health care law and nonprofits trained to help Texans purchase coverage packed a state meeting room in Austin on Friday and urged the insurance department to reject additional navigator oversight.

The United Way of Tarrant County, which received a $5.8 million federal grant to build a navigator network, would potentially need another $145,000 to meet the additional state requirements, said Tim McKinney, the group's president and CEO.

Republican state Rep. Kenneth Sheets supports the new rules, saying additional oversight is needed to protect consumers from fraud while enrolling.

Sheets said he's not worried about the extra stress new requirements might put on navigators, who he says are currently unqualified and could act as political operatives.

The agency could make its decision on the proposed rules as early as Jan. 7. The rules are supposed to be in place by March 1.

"Texas has tried every way they can to hurt the expansion of people getting insurance," said U.S. Rep. Gene Green, D-Houston. "I don't understand why the state wouldn't want to have Texans covered by health insurance. But, then, that's the governor's decision."

Associated Press writer Paul J. Weber in Austin contributed to this report.

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