News Column

As GOP Ponders Medicaid Expansion, Hispanic Support Hangs in the Balance

March 11, 2013

Jonathan Tilove, Austin American-Statesman

health

For Republicans nationally, the big takeaway from the 2012 presidential election was that, as a party, they have to get right -- or at least do better -- with Hispanic voters.

With the opening of the 83rd legislative session, the lessons of the 2012 election seemed to have taken here as well.

No provocative emergency items like in the last session, on sanctuary cities or voter I.D., issues that roused the Republican base but lacerated Hispanic sensibilities.

But on one issue, Gov. Rick Perry did draw a line in the sand.

"We have made it clear Texas will not expand Medicaid under the Affordable Care Act," he declared. "Texas will not drive millions more into an unsustainable system, and that stance has not changed an iota."

Perry's resistance to expanding Medicaid did not stir comment that he was being insensitive to the needs of Texas Hispanics.

But beneath a flurry of recent activity at the Capitol to find a "Texas solution" on Medicaid lurks an obvious, if mostly undiscussed, fact that the Hispanic community has the most to gain from expanding Medicaid, and that Republicans have the most to lose politically in their long-term relationship with Hispanic voters if they are seen as having denied so many Hispanics coverage just as it was within their grasp.

"Medicaid may have quietly eclipsed immigration reform as the major campaign issue standing in the way of the GOP drive to woo Hispanic voters. Hispanics, especially children, are disproportionately dependent on Medicaid, especially in Texas, the state with the greatest percentage of uninsured residents and with one of the largest Hispanic populations," said Frederick Lynch, a government professor at Claremont-McKenna College, who explored the nation's changing political demography in his 2011 book, "One Nation under AARP: The Fight over Medicare, Social Security, and America's Future."

"When it comes to the way Latinos are received by any political party, with regard to Republicans there is always that sort of anti-Latino sentiment, that's 1.0 -- that's the anti-immigrant, sanctuary cities, deport-them-all. And then you sort of have the anti-Latino sentiment that's 2.0, which is lack of support for public policy initiatives that disproportionately impact minority communities -- in this instance, Latinos, said state Rep. Trey Martinez Fischer, D-San Antonio, the chairman of the Mexican American Legislative Caucus.

"Everybody knows Texas is the poster child" for having the largest percentage of uninsured people in America, he said, and "3.6 million of the Texans who are uninsured are Hispanics."

According to the Kaiser Family Foundation's state health facts, those 3.6 million constitute 60 percent of the uninsured in Texas, and nearly a quarter of the 15.5 million Hispanic uninsured in the entire country.

"We're one of four states in the union that's majority-minority," said Texas GOP chairman Steve Munisteri, who said it's hardly surprising that in a state with such a large Hispanic population, Hispanics make up such a large share of the uninsured.

Gov. Perry has described Medicaid as a "broken" system that needs to be reformed, not expanded, and that to open its rolls to a huge new population in perpetuity would expose the state to crushing costs in the long term, even if the federal government kept its commitment to pay the lion's share.

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