The state’s uninsured don’t matter

When this legislative session in Texas ends, there will certainly be regrets about what was done — and what wasn’t.

Belonging at the top of the latter, barring some dramatic reversal of fortune, will be Texas’ unwillingness to provide health insurance coverage to those for whom it is now out of reach.

It isn’t as if the Legislature doesn’t know that Texas leads the nation in the number of uninsured folks. But pursuit of tax cuts has apparently sucked so much of the oxygen out from under the Capitol dome that seriously addressing this was out of the question.

Senate leadership did write a letter in March to the White House outlining conditions for Texas to expand Medicaid under the Affordable Care Act. The state’s health experts — and we suspect Lt. Gov. Dan Patrick — knew some of these conditions were so over-the-top that this proposal is likely a nonstarter. Some of the other requisites are already being done or already negotiated in other states. The letter didn’t constitute serious effort.

There was, however, an alternative that would have achieved many of the same goals. It was called the Texas Way, contains elements Texas Republicans said they wanted — and it appears to be dead.

If the Legislature adjourns without bringing relief to those without coverage, Gov. Greg Abbott should call it back into special session. But as Abbott also opposes Medicaid expansion, no one should expect this.

What was proposed — by Rep. Garnet Coleman, D-Houston, in the House and Sen. José Rodriguez, D-El Paso, on the other side — was not precisely outright expansion. This measure would have allowed Texas to negotiate a plan with the federal government that would have differed significantly.

What might have been: a market-based system requiring those covered to pay a portion of their medical expenses and providing other incentives for folks to stay healthy.

Such expansion could cover an estimated 1.2 million Texans and bring in $6 billion in federal dollars annually. The federal government would pay for 100 percent of expansion the first two years, the state contribution capped at 10 percent afterward. It would cover folks up to 138 percent of poverty.

We doubt if the capacity to feel shame exists in this Legislature. If it did, that’s precisely what the Legislature should feel if it adjourns without offering some hope to Texans without health coverage.