AUSTIN, Texas — By any measure, Texas’ health care system is a mess. But Gov. Greg Abbott, expected to coast to reelection in 2018, scarcely gives it a mention.
It’s quite a contrast from the state’s Senate race between Ted Cruz, the outspoken Obamacare foe who is seeking a second term, and Rep. Beto O’Rourke, the single-payer advocate trying to unseat him. Health care is a defining issue in that campaign.
There’s certainly plenty to talk about. Texas’ 16.6 percent uninsured rate leads the country, its maternal mortality rate is the worst in the developed world and rural hospital closures have hit large swaths of the state hard.
But Abbott rarely mentions any of that — even though it was his lawsuits against Obamacare when he was state attorney general that helped make him a national figure and Texas governor. Health care wasn’t mentioned once during his State of the State address this year or in his July address formally announcing his reelection bid.
“I know there is a lot of frustration with the giant portion of the budget that is spent on medical expenses on programs that everyone agrees is suboptimal,” said James Dickey, chairman of Texas’ Republican Party.
“It certainly shows a need for change sooner or later,” Dickey said. But “it has not come up in my discussions with the governor,” he added.
It isn’t just moderates who want him to cover more people who are frustrated. Conservatives are miffed that he isn’t trying to add conservative features to Medicaid under the Trump administration, which has encouraged states to apply for waivers. A number of red states are seeking waivers to add work requirements, tighten eligibility or make beneficiaries responsible for additional co-pays and other out-of-pocket costs.
But Abbott hasn’t moved, vexing conservative allies who think he’s squandering a unique opportunity to overhaul the program.
“What the governor is doing, honestly, I don’t understand,” said Deane Waldman, health care policy director at the conservative Texas Public Policy Foundation. “I would think something like this would fall on fertile ground.”
Perhaps, Waldman said, Abbott sees a Medicaid overhaul as too risky in an election year, even for a governor who is strongly favored to win a second term.
Moderates have largely abandoned efforts to prod Abbott to turn his attention to health care — but they want him to expand coverage through Obamacare’s Medicaid expansion. They’ve suggested conservative models from Republican governors in Kentucky and Indiana as possible examples…