AUSTIN, Texas (AP) -- About 1,000 protesters marched and rode wheelchairs to the Texas Capitol on Tuesday to demand that lawmakers fully fund Medicaid and expand it to include an additional 1.5 million poor people.
Disabled and low-income residents wearing yellow caps carried banners up Congress Avenue and chanted, "My Medicaid matters!" They were joined by their family members and dozens of groups from across the state.
After listening to speakers talk about their shared cause, protesters and their supporters headed inside the Capitol to lobby lawmakers.
Separately, hundreds of doctors in white lab coats met privately with legislators, asking for better reimbursement rates for treating Medicaid patients. Currently, the state only covers about 60 percent of the cost of treating recipients of the joint federal-state health care program for the poor and disabled. Doctors and clinics are expected to absorb the losses.
Under the Affordable Care Act, states have the opportunity to expand Medicaid coverage to low-income adults, with the federal government paying 85 percent of the cost over the next 10 years. The federal rules also would increase reimbursement rates to the same as those for Medicare, the government health insurance program for the elderly.
At least 26 states have agreed to expand Medicaid, but Texas Republicans insist the program already is too expensive for the state to operate and lacks enough doctors.
Gov. Rick Perry said he wants a waiver from the Obama administration that would allow Texas to receive the funding, ignore federal regulations and develop its own program.
DeAnn Friedholm, a former Texas Medicaid director who's now a health care expert with Consumers Union, said enrolling more people into the health program will lower local taxes and health insurance premiums by cutting back on the number of uninsured relying on emergency rooms for care.
Friedholm also called for a boost in Medicaid reimbursements.
"The biggest problem with Texas Medicaid today is that the payments for doctors are so far behind what other medical programs and private insurers pay that doctors can't or won't take Medicaid patients," she told a crowd on the Capitol steps. "Guess who's in charge of setting those rates? The Texas Legislature."
By spending $15 billion more on Medicaid over the next 10 years, the federal government would contribute $100 billion in matching funds and provide health care coverage for an additional 1.5 million Texans, she said. Texas currently has the highest rate of uninsured in the country at 24 percent.
"Texas Ranks (hash)50. Thank you Rick Perry for fighting so hard to keep it that way," read one sign mounted on a protester's wheelchair.
Perry spokeswoman Lucy Nashed said the governor's position has not changed, even after Republican governors in Florida, Michigan, New Jersey and Ohio agreed to Medicaid expansion.
"It would be irresponsible to add more Texans and dump more taxpayer dollars into an unsustainable system that is broken and already consumes a quarter of our budget," Nashed said.
Kenneth Russell drove from Houston to participate in the rally. He recently lost his job and health insurance and does not qualify for Texas Medicaid because he's a non-disabled adult. But he would be eligible for the program if lawmakers expanded it.
"I came here to tweak the governor's nose and let him know that we're watching him and we don't appreciate him not participating in expanded health care," Russell, 59, said. "Health care should be a right, and not for profit."
Separately, members of the Texas Medical Association met with lawmakers to ask them to support their legislative agenda. The association backs Medicaid expansion, but only if legislators provide reimbursement rates that will encourage more doctors to take on more patients. Otherwise, the system will break down, association members said.
Their group also wants lawmakers to expand medical education programs in the state, increase funding for mental health services and streamline billing and payment procedures.