Obama takes Texas to task for not expanding Medicaid

President Obama on Wednesday traveled to Dallas, Texas, where he met with supporters of his health care law, encouraging them to keep up their efforts to promote it, even in the face of conservative resistance. He specifically took state leaders to task for refusing to expand Medicaid -- an optional part of Obamacare.

"I know that sometimes this task is especially challenging here in the great Lone Star state," Mr. Obama said at Temple Emanu-El, where he addressed a group of "navigators" -- individuals tasked with helping people in their community sign up for insurance on the new marketplace. "But I think that all of you understand that there's no state that actually needs this more than Texas."

Under Obamacare, states have the choice to expand Medicaid so that it's available to anyone with an income under 138 percent of the federal poverty line. Currently, Medicaid exists as a joint federal-state program that provides health care to certain poor Americans, such as children and the elderly. So far, 25 states and the District of Columbia have decided to expand, but the remaining 25 states can decide to do so at any time in the future.

States continue to debate the issue, which hasn't always fallen along partisan lines. The GOP governors on board with the Medicaid expansion have pointed to the minimal fiscal impact it will have on state budgets -- for the first two years, the federal government pays for 100 percent of the expansion. Starting in 2017, the states start chipping in, but they will never contribute more than 10 percent of the cost.

"Across this state, you've got a million people -- because this is a big state -- a million people, citizens, who don't have health insurance who get insurance right away," Mr. Obama said, referring to Texans who would qualify for the expanded version of Medicaid. In the Dallas area alone, 133,000 people would qualify, he said.

"Over $500 million just for this county that would come into help families get health insurance... if the state of Texas made this decision," Mr. Obama said. Neighboring states consider it a "no-brainer," he added, pointing out that Arkansas has already reduced its uninsured population by 14 percent by expanding Medicaid.

"One of the things that sometimes gets me a little frustrated is folks who are complaining about how the website's not working, and 'why isn't Obama fixing this, and all these people are uninsured,' and yet they're leaving a million people right now without health insurance that they could immediately fix," the president said. "There's not a lot of logic to that."

Mr. Obama assured his supporters that as frustrating as the Obamacare implementation has been, "we are going to get this done."

He promised that HealthCare.gov, the dysfunctional Obamacare website, would be running smoothly by the end of the month, and he stressed the health law's several other benefits. It was worth it to keep advocating for the law, he said, "until everybody in Texas and everybody across this country has the affordable health care they need."

Before leaving for Dallas, Mr. Obama and Vice President Joe Biden met with 16 Senate Democrats at the White House to discuss the health care law's problems. Fifteen of those senators are up for re-election in 2014, and the 16th -- Sen. Mike Bennet, D-Colo. -- is chairman of the Democratic Senatorial Campaign Committee, the entity responsible for getting Democrats elected to the Senate. The president updated the senators on ongoing security tests in the new online marketplace, and he discussed efforts to reach out to people who have lost their insurance plans on the individual market.

Additionally, according to a statement from the White House, "The President emphasized that he shared the Senators' commitment to ensuring that Americans who want to enroll in health insurance through the Marketplaces are able to do so in time for insurance coverage to start as early as January 1st, and throughout the open enrollment period which goes through March 31."

Some Democrats are calling for an extension of the enrollment period in response to the HealthCare.gov problems. Sen. Mark Udall, D-Colo., said in a statement Wednesday that he pressed the issue during the White House meeting.

"The rollout of HealthCare.gov has not been smooth -- to say the least -- and I shared the concerns of Coloradans directly with the president," Udall said. "Consumers should have the time they need to shop for a plan and enroll after the widespread problems with the website are fixed."

Humana, one of the largest insurers on the Obamacare marketplace, told its investors Wednesday that it expects the administration to extend the period. "Our assumption is that there will be an extension to the open enrollment period," Humana Chief Operating Officer Jim Murray said during a call with investors to discuss quarterly results.

The administration has pushed back against that suggestion. At a congressional hearing earlier Wednesday, Health and Human Services Secretary Kathleen Sebelius stressed, "There's plenty of time to sign up for the new plans."

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