Texas Medicaid Expansion and Control of Epidemics

An Ebola case in Texas should give us pause to think about what Medicaid expansion would mean in controlling epidemics. Diseases know no jurisdictional boundaries and we should expect more isolated cases of Ebola. However, one or a few closely-connected cases of a disease are not an outbreak or epidemic. What stops an outbreak is the public health infrastructure including PREVENTIVE measures such as vaccines and sanitation standards, INVESTIGATIVE work such as lab testing and contact tracing and medical TREATMENT and care of patients.

“What does Medicaid expansion have to do with this?” you might ask. It provides access to care for those who lack resources. In Texas, you have to be very poor to qualify for Medicaid. Now, because of the Affordable Care Act, if your income is at least at or above the federal poverty level you can buy health insurance on a sliding scale making your out-of-pocket costs affordable. But what about the millions in that gap too “wealthy” for Medicaid but too poor for subsidized insurance? That is who Medicaid expansion is intended to cover, so that EVERYONE can go to a doctor when they are sick or to receive preventive vaccines and exams. Our federal tax dollars return to Texas, saving State government BILLIONS. Doctors and hospitals get paid for providing the care, 300,000 jobs get created and local taxpayers are freed from costs for uncompensated care.

Access to care is a huge part of preventing the spread of diseases like Influenza or Ebola.   For example, we currently have about 1 million food workers in Texas and, in part because of their substandard wages, many fall in that gap with no access to care and no paid sick leave. So, instead of seeing a doctor when they are sick with easily-transmitted colds and flu, they go to work, handling the food you eat and the plates or boxes you handle. YOU catch whatever they caught and the disease spreads.

An Ebola outbreak is not likely in Texas because it is hard to transmit, but we endure outbreaks of highly-contagious vaccine-preventable diseases like flu and measles (with dozens of deaths each year). There is NO economic or moral reason for Texas to refuse to expand Medicaid. Wendy Davis, as Governor, and Leticia Van De Putte as Lt Governor will do it, while their Republican opponents will not. Vote November 4 to protect everyone from disease outbreaks.

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