| Perspectives on Texas

When Republicans in Congress began working on our health care reform plan earlier this year, I asked folks from around the state to tell me about their experiences under Obamacare. The response was overwhelming.

I heard from one small business owner in Donna who was faced with an unthinkable decision: fire four employees just to comply with Obamacare’s mandates, or owe the government more than $100,000 in fines that could bankrupt his business. He didn’t have much of a choice.

Or take the Texan in Needville who, after having to stomach a 50 percent increase in his monthly premium, still lost his doctor — who wouldn’t accept his Obamacare plan.

Thousands more Texans, in emails, letters and phone calls, relayed similar stories — from difficulties with Medicaid to higher costs and poor coverage. Texans deserve better, and our plan delivers it.

Seven years ago, then-President Obama imposed a risky health care experiment on the nation. Today, the countless ways in which Obamacare has failed Texans are clear. Right now, one-third of Texas’ 254 counties have only one health care provider on the exchanges, and more than a half-million Texans can’t afford health insurance at all. Furthermore, only 41 percent of Texas doctors currently accept new Medicaid patients without restriction.* 

The draft plan Republicans released last month addresses the systemic problems at the root of Obamacare’s failure. The Better Care Reconciliation Act (BCRA) will help stabilize collapsing insurance markets, free Texans from the mandates requiring them to purchase insurance they don’t want and can’t afford, and lower average premiums over time. Importantly, our plan preserves access to care for people with preexisting conditions and allows children to stay on their parents’ health insurance plans through age 26. Finally, our plan strengthens Medicaid by giving states more flexibility while ensuring Texans who rely on it don’t have the rug pulled out from under them.

Despite acknowledging Obamacare’s failings, from the get-go Democrats in Congress made clear they had no interest in working with us to replace it. Instead, they have fought tooth and nail to preserve the health care status quo that’s failed so many Texans and people across the country. And they’ve made some dubious claims about our plan along the way.

A common refrain is that our plan ‘slashes’ Medicaid; in fact, under the Better Care Act, the nonpartisan Congressional Budget Office (CBO) estimates Medicaid spending will grow by $71 billion over ten years. Opponents also neglect people in states like Texas who fall into Obamacare’s ‘coverage gap,’ meaning their incomes are above Medicaid eligibility levels but below what would qualify them for subsidies. According to the Kaiser Family Foundation, as many as 600,000 low-income Texans fall into this category; under the BCRA, these folks would qualify for help in the form of tax credits not available to them under Obamacare.

Critics also claim our plan will kick millions of people off their insurance or make premiums too expensive to afford. This, too, is false: the BCRA gives people the ability, free from government mandate, to choose not to buy something they might not want. And the nonpartisan budget office estimated that under our plan average premiums will decrease by nearly one-third in three years.

Our draft bill, like any piece of legislation, can be strengthened. As the debate over our reform plan continues, the experiences of Texans will continue to guide my work. Health care is a deeply personal issue, and the passion reflected by that is evident on all sides of the debate. But one thing is clear: doing nothing to stop Obamacare from continuing to hurt millions of families in Texas and around the country is simply not an option.

[*Editor's note: An earlier version of this opinion piece cited an out-of-date Texas Medical Association study ont he number of doctors accepting Medicaid without restrictions. That's been updated, with a link to the most recent study.]