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So What Does No-Plan Medicaid Expansion Look Like?


Despite a lack of direction from the Texas Legislature, the state’s leading doctor is optimistic about how Texas will function without having a plan to address Medicaid expansion.  

Dr. Kyle Janek is the commissioner for the Texas Health and Human Services Commission and will be the chief negotiator when the state begins discussions with federal government on whether to extend Texas a waiver and award the state a block grant to start a state-run form of Medicaid.

Janek said his office is regularly in talks with the Centers for Medicare and Medicaid Services, the federal department that administers those programs, but have not have any specific conversations with them about how to cover the 1.5 million Texans without health insurance who would’ve been covered by a federal Medicaid expansion plan.

During the regular legislative session, two separate measures failed to pass that would have given Janek some direction on the Medicaid issue. 

Janek said there are other ways to get people the health coverage they need.

"We've got this safety net through the local hospital districts that are paid for with property taxes," he said. "All these things end up being resources to provide care to people at the local level outside of the Medicaid program. And so what I would say to them is just because it’s not an insurance card doesn’t mean government is not helping you get the healthcare that you need."

Janek said currently there is no timeline for when the state will negotiate the terms of a Medicaid waiver and a block grant.

"We are not the only state looking for block grant capability. The question is if the feds were not to give us that, how close to a block grant could we get," Janek said. "In the meantime, I don’t set up a timeframe, I take my orders from the governor and working with legislative leaders, and within the bounds of what the statute says, we’ll see if there is some room to negotiate."

Janek said he has a full plate just implementing non-Medicaid health bill that the legislature passed during the regular session. 

He said he can’t predict when Texas will hear back from the federal government in regards to being able to set up their own plan for addressing Medicaid expansion.

Ryan started his radio career in 2002 working for Austin’s News Radio KLBJ-AM as a show producer for the station's organic gardening shows. This slowly evolved into a role as the morning show producer and later as the group’s executive producer.