Such virulent opposition also has a chilling effect on enrollment in private insurance plans through the new federally facilitated marketplace. Without state leadership, community-based providers, including hospitals, are taking on the mantle of getting as many eligible Texans enrolled as possible. But there is widespread confusion and uncertainty among consumers with some even believing that the healthcare reform law was repealed. Much of this confusion could be remedied if state officials provided clear and unbiased information about the law.
Hospitals are casualties of this opposition. By rejecting the Medicaid expansion, the state leaves more than a million Texans—many of whom are working poor—without access to affordable coverage, and hospitals will continue to provide them with care often without sufficient compensation. In addition, because lawmakers opposed to Obamacare don't want to be seen as “fixing” it, they aren't acting to delay the reductions to disproportionate-share hospital program payments and Medicare reimbursement rates that were intended as coverage expansion pay-fors.
No, Obamacare isn't perfect. Texas hospitals share some of Gov. Rick Perry's concerns about Medicaid. Without coverage expansion, however, millions will remain uninsured, continue to receive care in the ER, increase providers' uncompensated care and shift costs to the privately insured.
