Longview, Texas—It was the day before Christmas when the state announced its first Medicaid expansion.
The program, launched by the federal government, is designed to offer health insurance to nearly 1.4 million Texans who live in rural areas and the city of Dallas.
The plan’s biggest benefit: The federal government will cover most medical costs, including emergency room visits and prescription drug costs.
The Medicaid expansion is one of a handful of state Medicaid expansions, along with a handful in Texas and Louisiana.
The federal program, however, has been riddled with problems and problems.
For starters, the federal program has never been widely adopted, despite the fact that most Americans are eligible.
The Affordable Care Act, which the Obama administration began rolling out in 2014, did little to address the lack of a federally funded health insurance system.
In addition, the expansion doesn’t have a set amount of money available for states to run it, and many counties have limited access to it.
In Texas, for example, there is only one insurer on the market, Aetna.
The state is also grappling with a shortage of qualified doctors and hospitals.
The problem was exacerbated by the high number of Texans in the Medicaid program who were not eligible for subsidies.
“I don’t think the federal exchange is going to work for everybody,” said Tom Davis, a Texas Insurance Commissioner who was elected in November to replace outgoing Insurance Commissioner Mike Perdue.
Davis said he was also frustrated with the state’s response to the Medicaid expansion, which was announced in December.
It was meant to cover about 6 million Texans, and about 90 percent of those eligible would qualify for Medicaid.
Davis, who has been outspoken in his criticism of the federal Medicaid program, said the new federal plan was rushed through Congress.
“There’s no accountability for that,” Davis said.
“It was all rushed through, and I think it will be a disaster.”
Davis said that the new plan also includes some provisions that will hurt low-income Texans.
It does not require health insurers to cover abortions, he said, and it does not allow insurers to raise premiums for lower-income consumers.
The Texas plan also does not cover the cost of mental health treatment or addiction treatment.
“You can’t be serious about getting these people into coverage,” Davis warned.
“The idea is to get these people out of there, and we can’t get them into the system.”
The new Medicaid expansion will cover only 1.5 million Texans by 2023, according to state officials.
In Texas, nearly half of all adults live below the poverty line.
That figure is higher than the national average of 45 percent, according the Census Bureau.
In some areas, the new program is being met with resistance.
In Houston, for instance, a small group of protesters called for a boycott of insurance companies in the new Medicaid program after a state official said the state would not accept any insurers who do not provide coverage for the uninsured.
State officials are also working to make the Medicaid system more efficient.
Some are trying to address a growing backlog of applications.
Officials in Texas are also developing a program to allow people to enroll in insurance through a local health care network.
The rollout of the health care law also created a huge challenge for the federal health insurance agency, the Centers for Medicare and Medicaid Services (CMS), which oversees Medicaid.
The agency is trying to figure out how to run the Medicaid rolls smoothly in order to attract more health insurers and patients to the program.
A key problem is that many insurers, including Aetan, UnitedHealthcare, Cigna and others, are not participating in the expansion, meaning they will not be covering nearly all eligible Texans.
Health insurance companies are also hesitant to participate in the health insurance expansion because they fear it will hurt their bottom lines.
Insurers are also struggling to pay for Medicaid enrollees who have been waiting months to get coverage.
Many also are struggling to recruit and retain qualified health care workers.
And in some cases, the state health department says it can’t afford to pay the health plans for staff to handle the newly eligible patients.
The health care expansion was supposed to help fill the gap left by the death of one of the last remaining members of the Texas family that had lived on their land in the mountains.
The elder John Henry Walker was 79 and was buried in a nearby cemetery.