Dallas Senator Nathan Johnson Renews Push to Expand Medicaid in Texas

AUSTIN — Senator Nathan Johnson, a Democrat from Dallas, is renewing his push to expand Medicaid in Texas, hoping to provide coverage to over 1 million low-income Texans. Despite facing an uphill battle in the conservative-dominated Texas Legislature, Johnson has filed Senate Bill 232 for the upcoming session, marking his third attempt to achieve Medicaid expansion under the Affordable Care Act.

The proposed legislation, titled the Live Well Texas program, offers a conservative-friendly approach. It combines Medicaid expansion with initiatives like health savings accounts, employment assistance, and incentives for healthy behaviors to encourage self-sufficiency. Additionally, the bill seeks to increase reimbursement rates for healthcare providers, which could enhance Medicaid patients’ access to hospitals, doctors, and other medical professionals.

Challenges in Gaining Support

Johnson’s efforts have historically faced resistance. In 2021, his Medicaid expansion bill garnered no Senate Republican support, though nine GOP House members joined 67 Democrats to co-author a similar bill. The measure, however, was stalled in committee.

The momentum waned further in 2023, as a contentious legislative session and the departure of moderate Republicans dimmed bipartisan cooperation. This session, with the Texas Legislature leaning even more conservative, Johnson acknowledges the slim odds but remains committed to the cause.

“Expanding Medicaid would benefit millions of Texans, providing them access to critical healthcare while reducing the burden on emergency services,” Johnson explained. “We owe it to our communities to explore every avenue to improve access to healthcare.”

The Broader Context

If successful, Texas would join 40 states and Washington, D.C., in expanding Medicaid under the Affordable Care Act. Proponents argue that expansion would reduce uncompensated care costs for hospitals and improve health outcomes for underserved populations. Critics, however, worry about the potential financial impact on the state budget.

As the session approaches, all eyes are on the Texas Legislature to see whether Medicaid expansion finally gains traction in a state that has resisted it for over a decade.