Interactive: Weighing Medicaid Expansion
Whether to expand Medicaid is the major health care question facing Texas legislators this session. Although Gov. Rick Perry has compared adding impoverished adults to the rolls of the state program to adding more people to the Titanic, Democrats and even some fiscal conservatives argue that expanding the program under the federal Affordable Care Act is a wise budgetary decision. The threat of the governor’s veto will make it difficult for advocates of expansion, but Democrats, some local government officials and some health care lobbyists are optimistic that lawmakers can find a route to expand Medicaid that circumvents the ...
Comments (3)
Gritsforbreakfast
You should also pay attention to the disproportionate share (DSH) funding hospitals will lose under Obamacare that currently pays for indigent defense costs. The ACA assumes states won't need as much because more people are insured, so if we don't do Medicaid expansion, hospitals will lose huge sums from that source. See a recent article on the topic from the New England Journal of Medicine: http://www.nejm.org/doi/full/10.1056/NEJMp1209450#t=article
Also, re: "the HHSC estimates that Texas would spend $16.4 trillion on Medicaid from 2013 to 2017, while the federal government would spend $31.6 trillion." Surely you mean "billions." Either way, Texas' number seems quite inflated compared to what's being projected in other states in the early years.
Richard Moore
Grits makes an excellent point – DSH payments to public hospitals will diminish regardless of the expansion rout chosen by Texas. The impact of this choice on Texas Public Hospitals should be thoroughly analyzed – this includes the potential impact on the Local Tax revenues these Hospitals receive.
If Texas expands Medicaid, the Public Hospitals will now receive payment (either by a Medicaid payment or a federally subsidized insurance payment) for the services to their previously “un-insured” patient base. This should have the effect of reducing the need for these revenues at the current Local Tax rate. The local Hospital District Taxes should be able to be reduced by a predictable amount. These are sizable taxes particularly in Dallas, Houston, Bexar and Travis counties.
Stuart Greenfield
So the state could receive a 1765% return on its investment of 68 bil and these guys are just considering implementing Medicaid expansion. Maybe I'll buy our legislators a calculator so they can do their numbers correctly.