Office of the Mayor

Malcolm Duncan, Jr. P.O. Box 2570 Waco, Texas 76702 (254) 548-4846 wacomayor@waco-texas.com

April 15, 2013 Texas House of Representatives Appropriations Committee Dear Committee Members: I am writing today to express our citys strong commitment to allowing our citizens access to healthcare through some form or fashion of Medicaid expansion. Our City Council, public school district board, and community college board have all passed resolutions in support of this measure. Our community is burdened with 28% of our citizens living below the federal poverty level, most of these without access to primary health care. Our best estimate is the expansion would allow over 28,000 county residents to have access to basic health services they currently do not. Our hospitals and family health center estimate the uncompensated burden in this county is close to $100 million and Medicaid expansion would cut this in half. We cannot in good faith ask our citizens and employers to bear this burden without extending maximum effort to secure the upfront Medicaid coverage. Our city and county currently support indigent and uncompensated care with the hospitals and family health center. We feel our local contribution would equal the 10% proposed state share over time and have worthwhile outcomes. We do not see this as a risky choice that would leave us with a financial hangover when the federal support changes, as we all know it will. Give us time to make a Texas solution work and put the local communities in the front - we bear the costs and see the results daily. Sincerely,

Malcolm Duncan, Jr. Mayor tm