Why Texas Republicans still oppose Medicaid expansion

One of two surgical suites at Eastland Memorial Hospital. Eighteen percent of Texans don’t have health insurance, the highest rate in the nation. (Credit: Gary Rhodes for The Texas Tribune)

One afternoon in April 2021, state Sen. Nathan Johnson sprinted through the Texas Capitol building, determined to reach the House chamber in time to see history made. For one of the few times since the Affordable Care Act was passed in 2010, the full Texas House was going to vote on a proposal to expand Medicaid, the program that provides health care to America’s poorest.

Eighteen percent of Texans don’t have health insurance — the highest rate in the nation — and Johnson had already filed five pieces of legislation that session to use Medicaid expansion to get as many as 1.2 million of those people insured.