1. Community Action Training Texas Medicaid Expansion February 9, 2013
Houston Area Medicaid Expansion Coalition
Not sure we can List endorsement of all these orgs. We need to bring it up at the Wed meeting.
Health Care for All Texas
ADAPT
AFL-CIO
Code Pink
Good Jobs = Great Houston
Green Party
Houston Center for Independent Living
Houston Peace and Justice Center
Houston United
SEIU
Texas Women United
Working America 1

2. Introductions Health Care for All Texas Host – Richard Shaw, AFL-CIO
Greeters
Facilitators
Need to check with Richard
Scratch special HCFAT intro go around the room for introductions , Name, org if any, why you came 2

3. Small Group Exercise #1 A. Tell your Medicaid story in 2 minutes
I am here today because…
My story is about…
What happened is…
It's just not right that…
B. Write down the questions you would like to have answered today 3

4. What is Medicaid in Texas Today?
Federal $ (60%) + state $ (40%)
Provides health care for:
Children from low-income families
Low-income pregnant women
Low-income people with disabilities
Low-income seniors, including
those in nursing homes (most of Medicaid funds go to nursing homes)

5. Currently in Texas…
2.6 million children receive Medicaid today, but only about 225,000 of their parents are covered.
A single parent with two children has to make less than $308 per month to qualify for Medicaid.
The Texas Legislature set the income limit for parents in It has never been increased.
Parent with Children 5

6. Threats to Current Medicaid
Last year, Medicaid was underfunded by more than $4 billion of State funds.
They left out of the budget the State matching money for the last 6 months of 2013.
Now there is talk of more damaging cuts, block grants, waivers, or caps that will harm families and our communities.

7. What is the Medicaid Expansion?
Under the new healthcare law (Affordable Care Act, Obamacare) adults with incomes up to 138% of the Federal Poverty Level (FPL) ($15,400 for an individual and $31,800 for a family of 4) will be eligible for Medicaid.
When the Supreme Court approved the law they made the expansion optional for the states.

8. What is the Medicaid Expansion?
Governor Perry and other Republican governors mainly in the south have said that they will not implement the Medicaid expansion.

9. Why Medicaid Should be Expanded
4 Talking Points
Why Medicaid Should be Expanded

10. TP #1: It will save lives.
“9,000 people will lose their lives every year because they don't have access to health care if we don't get the Medicaid expansion in Texas.”
Dr. Howard Brody, director
Institute for Medical Humanities
University of Texas Medical Branch
Galveston
This is everybody's problem

11. 6.2 million Texans are without health insurance
The Crisis
6.2 million Texans are without health insurance
The most uninsured people in any state in the nation!
1 in 4 people

12. Everyone's Health Counts
Our health as individuals is tied to the health of everyone in our community
All the children in our classrooms
All our neighbors
All our coworkers
All the people we encounter every day
All means all, not just citizens

13. TP #2: It's for the well being of Texas families.
Texas Medicaid covers about 2.6 million children today…
…but only about 225,000 of their parents
2,036,000 more people earning low wages, many of them parents, will
be eligible 13

14. TP #3: Everyone Pays Less When People Have Insurance!
If people don't have health insurance they go to emergency rooms
Too often it’s a serious emergency because there was no way to see a doctor before it was serious
Hospitals move those cost over to people with insurance
Insurance companies charge higher rates
Local taxes rise to pay for health services for the uninsured, like Ben Taub & LBJ

15. Federal money to safety net hospitals will be cut
Right now, money comes from the federal government to reimburse hospitals that serve people without insurance.
Under the new healthcare law that money goes away. About $1 Billion a year in Texas.
The law assumed that hospitals would get that money through the Medicaid expansion.
If there is no Medicaid expansion in Texas, those hospitals will have less money for needed services.

16. Where will safety net hospitals get the money? …
Local taxes and property taxes are their only other funding sources.
By rejecting the Medicaid expansion, Texas would give away federal tax money already collected from Texans to other states and would need to raise our local taxes.
Graphic indicating “Stupid” 16

17. TP #4: It’s a fantastic deal for Texas.
$100 billion over 10 years (Federal share)
-$15 billion over 10 years (State share)
$85 billion net gain for Texans

18. The Medicaid Expansion costs Texas only 10%
For the Medicaid expansion:
Currently:
Federal share
60%
Federal share
90%
State share
40%
State share
10%

19. More Money
For every dollar Texas spends matching this federal money, there will be:
$1.29 generated in state revenue
+$.51 generated in local gov. tax collected
+$1.21 saved by local governments
$3.01 growth in the Texas economy $1
Texas matching funds

20. More Jobs More money to provide health care will mean more: Physicians
Nurses
Therapists
Laboratory technicians
Other health care workers
Those new jobs will mean more people will be spending more money, making a healthier economy and creating even more jobs.

21. Review the 4 Talking Points
#1: It will save lives.
#2: It's for the well being of Texas families.
#3: Everyone pays more for people without any insurance!
#4: It’s a fantastic deal for Texas.
L. F. E. P. D.

22. It's not all peaches and cream
Warning!
It's not all peaches and cream

23. Who will gain from the Medicaid expansion?
People
Hospitals
Insurance companies
The good news is that the hospitals and insurance companies will get Governor Perry’s attention and make the expansion of Medicaid more likely despite what he is saying now.

24. All People in Texas Medicaid must be in Managed Care
In Texas, private insurance companies manage the care for people on Medicaid and make a profit for doing it.
Last summer Wellpoint, the 2nd largest for- profit health insurance company in the country, bought Amerigroup, the largest Medicaid managed care company in Texas. They are betting on the expansion.

25. The For-profit Insurance Companies and The People….
We both want the Medicaid expansion, but our interests are not the same!!
For-profit health insurance is mostly responsible for the high cost of healthcare today, which has left out so many people.
They might like a “compromise” plan to increase Medicaid out-of-pocket costs.

26. Threats to add co-pays and deductibles
Asking for permission from the federal government to add more out-of-pocket costs has already been mentioned by Texas legislators.
Those added costs would prevent people from going to the doctor when they need to.
Politicians would say that it “lowers costs” while insurance companies continue to make their profit.

27. Many people will still be left out
As long as we have a healthcare system based on for-profit health insurance that makes money by limiting care, many of us will be left out.
Insurance companies play us against each other so they can make more profit.

28. The Way Forward…. We must not be divided!!
Fight for the Medicaid Expansion, but also to protect those on Medicaid today.
Fight for Education funding – It can’t be Education versus Health Care. It must be both!

29. The “Healthcare System”
Our “healthcare system” is a jumble of public programs and thousands of private insurance plans designed for profit.
The waste is tremendous!!
We are the only advanced country that will not provide healthcare to all, even if the new law were to be fully implemented.

30. The Goal !!!
Until there is a real national healthcare system based on need, not ability to pay and profit, we will continue the fight.
The way to achieve that system is through an Improved Medicare without private insurance, Expanded to All.
I think the Action slides Should be consolidated into a one page handout included in the packet. 30

31. The Medicaid Expansion should be a “No-Brainer”
Even Gov. Jan Brewer (R) of Arizona said:
“By agreeing to expand our Medicaid program, we will:
Protect rural and safety-net hospitals from being pushed to the brink by their growing costs in caring for the uninsured;
Take advantage of the enormous economic benefits – inject 2 Billion dollars into our economy – save and create thousands of jobs; and,
Provide health care to hundreds of thousands of low-income Arizonans."

32. What are your burning questions?